Acute Myelogenous Leukemia in Pregnancy in a 32yr Old Woman

Abstract

Background: Generally a disease of the elderly, Acute Myelogenous Leukemia (AML) very rarely occurs in pregnancy with an estimated incidence of 1 in 75,000 - 100, 000 pregnancies1, 2. There is hardly any data on the difference in its incidence between pregnant women and non-pregnant women in the reproductive age. However, management options are more in the non-pregnant, as
they are in the elderly. Because there is yet no globally agreed standard way of managing this clinical dilemma in pregnancy, various institutions have proposed different management protocols depending on the AML type, degree of symptomatology, gestational age at diagnosis and the patient’s wishes. The objective of this publication is to present our experience with this condition at the Korle Bu Teaching Hospital, to bring attention to the possibility of the condition in our environment as part of differential diagnoses of anaemia or coagulopathy in pregnancy. 
Case: We report the case of a 32yr old G3P1+1A, at 32weeks 2days gestation diagnosed with and managed for Acute Myeloid Leukemia at the Korle Bu Teaching Hospital, and review of the available literature on this condition in pregnancy.
Conclusion: Acute Myelogenous Leukemia is a very rare condition in pregnancy that lacks universally accepted treatment protocols. Management can pose a challenge to clinicians, patients and their relatives. Early accurate diagnosis is difficult in resource-constrained
settings, and management options are limited when trying to save both fetus and mother. Early accurate diagnosis and prompt referral for appropriate interventions are key in improving outcomes, even in the face of other obstetric complications.