Maternal and Perinatal Outcomes in Pregnancy with Leukemia: A Tertiary Institution Experience of 12 Pregnancies for 5 Years

Abstract

Pregnancy with Leukemia is a rare but serious condition, with a global prevalence of about 1 in 75,000 to 100,000 pregnancies. The simultaneous occurrence of pregnancy and leukemia presents a complex therapeutic dilemma for patients, hematologists, and obstetricians. This study is a serial case study that collected data on pregnant patients with leukemia treated at dr. Soetomo Teaching Hospital. The data includes demographic characteristics, types of leukemia, age at diagnosis, age during pregnancy, as well as clinical and laboratory manifestation and their maternal and perinatal outcomes. Of the 12 identified cases, 8 cases (66.7%) were Chronic Myeloid Leukemia (CML), 2 cases (16.7%) were Acute Myeloid Leukemia (AML), and 2 cases (16.7%) were Acute Lymphocytic Leukemia (ALL) and there were no cases of Chronic Lymphocytic Leukemia (CLL). The average age of patients at diagnosis was 23 years, and age during pregnancy was 25 years. The prevalence of pregnancy with leukemia at dr. Soetomo Teaching Hospital is 1 in 482 deliveries, possibly due to the hospital's status as a tertiary referral center with adequate cancer services in East Java Province. The worst maternal and perinatal was AML, whereas all pregnant women with AML has died. The best maternal and perinatal outcome was CML. Chronic Leukemia showed better maternal and perinatal outcomes compared with acute leukemia. This study highlights the importance of proper management and coordination between hematology and obstetricians to achieve optimal outcomes for both the mother and the fetus.