Gebelik sırasında ortaya çıkan ve başarı ile tedavi edilerek sağlıklı bir doğumla sonuçlanan akut myeloblastik lösemi: Olgu sunumu

Amaç: Akut lösemi, gebelik sırasında ortaya çıkan nadir bir komplikasyondur. Uygun tedavinin verilmesi ve bunun fetüse verebileceği olası zarar nedeni ile genellikle ikilemde kalınır. Anne açısından acilen tedaviye başlamak gerekirken, fetus üzerindeki olası teratojenik etkiler kararın gecikmesine yol açabilmektedir. Olgu sunumu: Ondokuz yaşında, gebeliğin otuzuncu haftasındaki kadın hastaya akut myeloblastik lösemi tanısı konuldu. Sitozin arabinozid (100 mg/m2, İV, 1-7 gün) ve daunorubisinden (50 mg/m2, İV, 1-3 gün) oluşan kemoterapi protokolü remisyon-indüksiyon amacı ile başlandı. Hastalığın remisyona girmesini takiben gebeliğin 37. haftasında sezeryanla doğum gerçekleştirildi. Konsolidasyon amacı ile bir ay arayla 2 kez yüksek doz sitozin arabinozid (6 g/m2/gün, İV, 1-3. gün) uygulandı. Şu anda hem hasta hem de bebeği hayatta ve sağlıklıdırlar. Sonuç: Gebelik sırasında ortaya çıkan lösemi olgularının tedavisi geciktirilmemeli ve mümkün olan en kısa zamanda başlanmalıdır.

Anahtar Kelimeler:

Erişkin, Sitarabin, Daunorubisin, Kadın, Lösemi, miyelositik, akut, Gebelik, Gebelik komplikasyonları, neoplastik, Gebelik sonucu, Tedavi sonucu

Successful treatment of acute myeloblastic leukemia during pregnancy resulting in a safe delivery: Case report

Objective: Acute leukemia is a rare complication of pregnancy. There is almost always a conflict between optimal maternal therapy and fetal well-being. The maternal interest is for an immediate treatment of malignancy. However, possible teratogenic effects may delay the treatment. Case report: Nineteen years old woman in the 30th week of pregnancy was diagnosed acute myeloblastic leukemia. Cytosine arabinoside (100 mg/m2, IV, 1-7 day) and daunorubicin (50 mg/m2, IV, 1-3 day) were started for remission induction. When disease was in remission, caesarian section was performed on the 37th week of gestation. High dose cytosine arabinoside (6 g/m2/gün, IV, 1-3. day) was applied for 2 times in one month interval as consolidation. She and her baby are in good health. Conclusion: Treatment of pregnancy associated leukemia should not be delayed and should be started as soon as possible.

Keywords:

Adult, Cytarabine, Daunorubicin, Female, Leukemia, Myelocytic, Acute, Pregnancy, Pregnancy Complications, Neoplastic, Pregnancy Outcome, Treatment Outcome,

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