CONCEPTION AND PREGNANCY IN A PATIENT WITH CHRONIC MYELOCYTIC LEUKEMIA UNDER CONTINUOUS COLCEMIDE THERAPY

Abstract

Pregnancy concurrent with leukemia is rare. Review of the literature on this subject indicates that pregnancy does not aggravate this disease and that interruption of pregnancy is not beneficial. However, treatment of pregnant women with irradiation or chemotherapeutic agents may be dangerous. We have observed a patient with chronic myelocytic leukemia who became pregnant while under treatment with Colcemide (demecolcine) and antimitotic agent. Administration of 170 mg of this drug within a 2-month period resulted in complete remission with disappearance of subjective symptoms, regression of spleen, and normalization of the peripheral blood counts. When the pregnancy was discovered the patient was already nearing the end of the 1st trimester. It was decided to permit pregnancy to continue and to maintain the patient on Colcemide, because the period of presumed greatest danger to the fetus had already passed. This decision was aided by several reports of normal infants born to women treated with other chemotherapeutic agents during pregnancy. Colcemide was administered continuously throughout pregnancy and did not produce any detectable fetal abnormalities. Several possible explanations for this are discussed. The drug may not pass the placental barrier in toxic amounts, or the fetal blood forming organs may be more resistant to Colcemide than the maternal bone marrow. Also, it is possible that some depression of fetal blood cell formation may have occurred during pregnancy, with recovery prior to delivery.