Recurrent hairy cell leukemia during pregnancy: A case report

Patsner, Bruce; Penney, R W; Walsh, Christina

doi:10.1016/s0002-9378(94)70163-6

Cited by 7 publications

(4 citation statements)

References 2 publications

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“…From the cases of HCL found in the literature, one case was managed expectantly [165], two cases were treated with interferon alpha [153], two cases underwent splenectomy during pregnancy [166,167], and one case opted for termination of pregnancy [168]. All neonates were healthy and delivered without complications; however, long-term data is not available.…”

Section: Hairy Cell Leukemiamentioning

confidence: 99%

Management of hematological malignancies during pregnancy

et al. 2009

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The management of hematological malignancies during pregnancy is a challenging endeavor, which not only requires technical skills and knowledge by the clinicians but also requires sound clinical judgment and compassion, keeping in mind the patient and family preferences and, ultimately, the wellbeing of the neonate. The incidence of hematological malignancies during pregnancy is rare, ranging from 1 in 1,000 to 1 in 10,000 deliveries, impeding the design and execution of large prospective studies. The purpose of this review is to evaluate the limited existing data and make useful suggestions in the management of acute and chronic leukemias, Hodgkin and non‐Hodgkin lymphomas, plasma cell myeloma, and other hematological malignancies, such as myelodysplastic syndromes and hairy cell leukemia, during pregnancy. Am. J. Hematol. 2009. © 2009 Wiley‐Liss, Inc.

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Section: Hairy Cell Leukemiamentioning

confidence: 99%

Management of hematological malignancies during pregnancy

et al. 2009

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“…On the basis of case reports, successful modern treatment modalities for CML include leukapheresis (Nolan et al 1988;Bazarbashi et al 1991), hydroxyurea (Patel et al 1991), and interferon-a (Baer et al 1992;Crump et al 1992). Pregnancy complicated by hairy cell leukemia is very rare and can also safely be treated with standard therapy using interferon-a (Williams 1987;Baer et al 1992;Alothman and Sparling 1994;Patsner et al 1994).…”

Section: Leukemiamentioning

confidence: 99%

Cancer in pregnancy: maternal-fetal conflict

Oduncu

Kimmig

Hepp

et al. 2003

J Cancer Res Clin Oncol

103

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The occurrence of malignancies during pregnancy has increased over the last decades. They complicate approximately 1 per 1000 pregnancies. The most common malignancies associated with pregnancy include malignant melanoma, malignant lymphomas and leukemia, and cancer of the cervix, breast, ovary, colon and thyroid. Since it is impossible for prospective randomized clinical trials to be conducted in this field, relevant data have been generated from case reports and matched historical cohort studies in order to evaluate the treatment outcomes and the issues complicating the management of malignancy in the pregnant patient. There is almost always a conflict between optimal maternal therapy and fetal well-being. The maternal interest is for an immediate treatment of the recently diagnosed tumor. However, the optimal therapy, be it chemotherapy, radiotherapy or surgery, may impose great risks on the fetus. Consequently, either maternal or fetal health, or both, will be compromised. Therefore, both the pregnant patient and her physician are often in a dilemma as to the optimal course. On the basis of the medical facts, we discuss the issues raising potential ethical conflicts and present a practical ethical approach which may help to increase clarity in maternal-fetal conflicts. We review the available data informing the incidence and impact of the most common malignancies during pregnancy and their treatment on both the pregnant woman and her fetus. The optimal therapy for the tragic diagnosis of cancer in pregnancy requires a collaborative and interdisciplinary approach between gynecologists, oncologists, obstetricians, surgeons, neonatologists, psychologists, nursing staff and other disciplines. The purpose of this article is not to answer specific questions or to construct management schemes for specific tumors but to provide a framework for approaching some of these complex issues.Keywords Cancer in pregnancy AE Maternal-fetal conflict AE Patient autonomy AE Maternal beneficence AE Fetal beneficence Conflicts raised by issues complicating the management of ''cancer in pregnancy'' Any choice of the best possible treatment option for pregnant women with cancer has to be based on precise medical facts. However, there are-arising from the special constellation of concomitant cancer and pregnancy-a number of issues seriously complicating the management of malignancy in the pregnant patient. Severe conflicts arise concerning the health and life of the mother and fetus by the diagnosed tumor and its therapy. One major conflict is the question: Should the therapy of choice be different in the presence of a pregnancy? The presence of a pregnancy aggravates the situation for the physician and the patient because the decision made needs to take into account the interests of the mother and the fetus. Possible conflicts are raised by different issues which complicate the management of cancer in the pregnant woman in a distinctive manner different to tumor therapy outside pregnancy. The complicating issues relate to (1) medical...

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“…In rare cases, the thrombocytopenia may be the first presenting feature of a hematological malignancy with this incidence ranging from one in one thousand to one in ten thousand pregnancies; subsequent management remains a challenging endeavour [4]. Of those hematological malignancies reported during pregnancy, hairy cell leukemia (HCL) is exceedingly rare [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Hairy Cell Leukemia Masquerading as Pancytopenia in Pregnancy

Shackleton

Langabeer

O’Brien

et al. 2019

Case Reports in Hematology

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Thrombocytopenia is one of the most common hematological abnormalities observed during pregnancy, and in rare cases, this may be the first indicator of an underlying hematological malignancy. Hairy cell leukemia (HCL) is an uncommon B-cell lymphoproliferative disorder of which thrombocytopenia is a recurrent presenting feature. A case of pancytopenia presenting in pregnancy is described in which the thrombocytopenia persisted postpartum coincidental with a vesicular, pustular rash characterised as Sweet’s syndrome. Hematological, histological, immunophenotypic, and molecular investigations confirmed the presence of HCL. The patient was treated with cladribine resulting in resolution of Sweet’s syndrome, hematological remission from HCL, and achievement of a normal platelet count. This case highlights the need to maintain a wide differential diagnosis for presentations of pancytopenia or thrombocytopenia in pregnancy and the requirement for follow-up investigation of unusual cases with a lack of response to steroids or immunoglobulin.

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Recurrent hairy cell leukemia during pregnancy: A case report

Cited by 7 publications

References 2 publications

Management of hematological malignancies during pregnancy

Management of hematological malignancies during pregnancy

Cancer in pregnancy: maternal-fetal conflict

Hairy Cell Leukemia Masquerading as Pancytopenia in Pregnancy

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