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However, administration of chemotherapy and differentiating agents in pregnancy is controversial because of potential teratogenic effects. In addition, complications associated with APL, including retinoic acid syndrome, add to the complexity of management. To better understand how to manage this complex patient care situation, we searched the PubMed database (January 1972\u2010May 2008) for English\u2010language articles about maternal and fetal outcomes resulting from APL treatment during pregnancy. A total of 42 cases from 35 articles were identified: 12 first\u2010trimester, 21 second\u2010trimester, and 9 third\u2010trimester cases. The most commonly administered agents were all\u2010<jats:italic>trans<\/jats:italic>\u2010retinoic acid (ATRA), anthracyclines, and antimetabolites. Complete remission was reported in 35 (83%) of 42 patients. Administration of ATRA or chemotherapy in the first trimester was associated with an increased risk of fetal malformations and spontaneous abortion, whereas administration in the second and third trimesters was associated with relatively favorable fetal outcomes. The overall treatment of the pregnant patient with APL should include a discussion about pregnancy termination, especially if APL is diagnosed in the first trimester. If the pregnancy is to continue, then the appropriate chemotherapy regimen needs to be determined. Frequent fetal monitoring, along with aggressive management of potential APL\u2010related complications, is necessary to allow for optimal maternal and fetal outcomes.<\/jats:p>","DOI":"10.1592\/phco.29.6.709","type":"journal-article","created":{"date-parts":[[2009,5,28]],"date-time":"2009-05-28T22:02:24Z","timestamp":1243548144000},"page":"709-724","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Treatment of Acute Promyelocytic Leukemia During 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