Chronic Lymphocytic Leukemia in Pregnancy: A Review of the Available Literature and the Pharmacological Challenges in Management.

Autor:	Badr A; College of Medicine, Qatar University, Doha, Qatar., Benkhadra M; Pharmacy Department, National Center for Cancer Care and Research, Doha, Qatar., Elsayed B; College of Medicine, Qatar University, Doha, Qatar., Metwally O; College of Medicine, Qatar University, Doha, Qatar., Elhadary M; College of Medicine, Qatar University, Doha, Qatar., Elshoeibi AM; College of Medicine, Qatar University, Doha, Qatar., Ghasoub R; Pharmacy Department, National Center for Cancer Care and Research, Doha, Qatar., Elshoeibi RM; Faculty of Medicine, Mansoura University, Mansoura, Egypt., Alshemmari S; Department of Medical Oncology, Kuwait Cancer Control Center, Kuwait City, Kuwait., Mattar M; Clinical Hematology, Cairo University, Cairo, Egypt., Alfarsi K; Department of Hematology, Sultan Qaboos University Hospital, Al-Khod, Oman., Yassin M; College of Medicine, Qatar University, Doha, Qatar.; Hematology Section, Medical Oncology, National Center for Cancer Care and Research, Doha, Qatar.
Jazyk:	angličtina
Zdroj:	Oncology [Oncology] 2024 Jul 31, pp. 1-13. Date of Electronic Publication: 2024 Jul 31.
DOI:	10.1159/000540650
Abstrakt:	Background: Chronic lymphocytic leukemia (CLL) is a rare hematologic malignancy to occur in pregnancy, with an estimated incidence of 1 in 75,000 pregnancies. Pregnant women with CLL face increased susceptibility to infections, due to a weakened immune system. Higher risks of fetal malformations and death are associated with CLL treatment during pregnancy, emphasizing the need for careful consideration and management in these cases. Summary: This review aimed to summarize the current evidence regarding the diagnosis, prognosis, and treatment of CLL in pregnant cases. A comprehensive search strategy was employed across multiple databases, yielding 14 case reports for inclusion. The cases were divided based on CLL diagnosis onset, either before or during pregnancy. Our results showed that patients diagnosed during pregnancy (n = 5) were mostly asymptomatic at diagnosis, with management ranging from supportive care to leukapheresis and transfusions. Postpartum treatment varied, with some patients requiring no additional therapy and others receiving chemotherapy. Pregnancy outcomes were generally favorable, with most neonates born healthy at term. However, one case of Richter transformation resulted in maternal death despite treatment. Among patients with pre-existing CLL (n = 9), the majority experienced an indolent course during pregnancy, with only supportive care required. A few cases necessitated treatment due to progressive disease or complications, including chemotherapy, leukapheresis, and splenectomy. Key Messages: This review highlights the heterogeneous nature of CLL in pregnancy and the importance of individualized management based on disease severity, gestational age, and maternal-fetal risks. Close monitoring, supportive care, and a multidisciplinary approach are essential for optimizing outcomes in this rare and complex clinical scenario. (© 2024 The Author(s). Published by S. Karger AG, Basel.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu