Arsenic Trioxide Treatment during Pregnancy for Acute Promyelocytic Leukemia in a 22-Year-Old Woman.


Journal

Case reports in hematology
ISSN: 2090-6560
Titre abrégé: Case Rep Hematol
Pays: United States
ID NLM: 101576456

Informations de publication

Date de publication:
2020
Historique:
received: 27 07 2019
revised: 23 09 2019
accepted: 07 02 2020
entrez: 2 4 2020
pubmed: 2 4 2020
medline: 2 4 2020
Statut: epublish

Résumé

Acute leukemia during pregnancy is rare (1 for 100000 pregnancies). The association of arsenic trioxide (ATO) and all-trans retinoic acid (ATRA) is known as the best therapy in standard-risk acute promyelocytic leukemia (APL). We describe the first case of a pregnancy with ATRA and ATO reported in the literature. In March 2018 at the University Hospital of Besançon, a 22-year-old woman was diagnosed with APL at 14 weeks of gestation (WG). She received a total of 2160 mg of ATRA and 930 mg of ATO between 14 and 35 WG. The mother's cytological remission was very fast. No maternal or fetal complications occurred during pregnancy. The pediatrics outcomes were good. Many case reports about ATRA exposure during the second and third trimesters report no serious adverse effect for pregnancy. ATO is teratogenic, genotoxic, and carcinogenic and passes through the placenta. Fetal exposure seems to be associated with bad pregnancy outcomes (preterm delivery, decreased birth weight, and fetal loss) and with lung diseases in young adults. No clinical trial is obviously possible, and the only data available are environmental exposure or animal studies. This case report may help medical teams to make hard decision for a treatment of APL during pregnancy.

Identifiants

pubmed: 32231816
doi: 10.1155/2020/3686584
pmc: PMC7086430
doi:

Types de publication

Case Reports

Langues

eng

Pagination

3686584

Informations de copyright

Copyright © 2020 Claire Cochet et al.

Déclaration de conflit d'intérêts

The authors declare that they have no conflicts of interest.

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Auteurs

Claire Cochet (C)

University Hospital of Besancon, Department of Obstetrics, Besançon F-25000, France.

Marion Simonet (M)

University Hospital of Besancon, Department of Hematology, Besançon F-25000, France.

Julie Cattin (J)

University Hospital of Besancon, Department of Obstetrics, Besançon F-25000, France.

Jean-Patrick Metz (JP)

University Hospital of Besancon, Department of Obstetrics, Besançon F-25000, France.

Ana Berceanu (A)

University Hospital of Besancon, Department of Hematology, Besançon F-25000, France.

Eric Deconinck (E)

University Hospital of Besancon, Department of Hematology, Besançon F-25000, France.
University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon Tumeur/Ingénierie Cellulaire et Génique, Besançon F-25000, France.

Etienne Daguindau (E)

University Hospital of Besancon, Department of Hematology, Besançon F-25000, France.

Françoise Schillinger (F)

Etablissement Français du Sang Bourgogne Franche Comté, Laboratoire d'hématologie-Immunologie-Biologie Moléculaire, Besançon F-25020, France.

Pierre Fenaux (P)

Saint Louis Hospital, Paris Diderot University, Paris F-75010, France.

Nicolas Mottet (N)

University Hospital of Besancon, Department of Obstetrics, Besançon F-25000, France.

Yohan Desbrosses (Y)

University Hospital of Besancon, Department of Hematology, Besançon F-25000, France.

Classifications MeSH