Pregnancy in a Woman With Chronic Neutrophilic Leukemia

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 121 Part 2; no. 2 Pt 2 Suppl 1; pp. 457 - 460
• Main Authors: Taylor, Jolyn, Roboz, Gail J, Baergen, Rebecca N, Genc, Mehmet R
• Format: Journal Article
• Language: English
• Published: United States The American College of Obstetricians and Gynecologists 01.02.2013
• Subjects: Abdominal Cavity - surgery; Adult; Anemia - etiology; Antineoplastic Agents - therapeutic use; Cesarean Section, Repeat; Erythrocyte Transfusion; Female; Humans; Infant, Newborn; Leukemia, Neutrophilic, Chronic - complications; Leukemia, Neutrophilic, Chronic - therapy; Leukocytosis - etiology; Platelet Transfusion; Postoperative Hemorrhage - etiology; Postoperative Hemorrhage - surgery; Pre-Eclampsia - drug therapy; Pregnancy; Pregnancy Complications, Neoplastic - therapy; Splenomegaly - etiology; Thrombocytopenia - etiology
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/AOG.0b013e3182736e76

BACKGROUND:Chronic neutrophilic leukemia is a rare myeloproliferative disorder in women of reproductive age. CASE:A pregnant woman with an established diagnosis of chronic neutrophilic leukemia presented at 26 weeks of gestation with splenomegaly, thrombocytopenia, leukocytosis, and anemia. Thrombocytopenia was refractory to medical treatment and, in part, was attributed to splenic sequestration. She delivered a healthy neonate at 35 weeks of gestation by repeat cesarean delivery under general anesthesia. Her preoperative platelet count was 30,000/mL and she was transfused platelets throughout the perioperative period. Her postpartum course was complicated by intraabdominal hemorrhage and severe preeclampsia. She recovered with intensive medical and surgical management. CONCLUSION:Chronic neutrophilic leukemia poses difficult challenges during pregnancy and requires a multidisciplinary approach.