{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:08:27Z","timestamp":1792177707898,"version":"4.4.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81730003, 81870120, 81900151, 82070187"],"award-info":[{"award-number":["81730003, 81870120, 81900151, 82070187"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004608","name":"Natural Science Foundation of Jiangsu Province","doi-asserted-by":"publisher","award":["BK20171205, BK20190176"],"award-info":[{"award-number":["BK20171205, BK20190176"]}],"id":[{"id":"10.13039\/501100004608","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Acute leukemia during pregnancy (P-AL) is a rare disease with limited data regarding the management and outcomes of mothers and fetuses. We retrospectively analyzed the characteristics, pregnancy outcomes and maternal and neonatal prognoses of 52 patients with P-AL collected from January 2013 to December 2020 in our center. Seventeen (32.7%) patients received chemotherapy during pregnancy (exposed cohort), while 35 (67.3%) received chemotherapy after abortion\/delivery (nonexposed cohort). Twenty-six (50.0%) pregnancies ended with abortion, and 26 (50.0%) babies were born through spontaneous delivery or cesarean section. Seven infants (26.9%) were born in the exposed cohort, while 19 infants (73.1%) were born in the nonexposed cohort. Fetuses in the exposed cohort had lower gestational ages (P=0.030) and birth weights (P=0.049). Considering the safety of the fetus, seven patients in the exposed cohort received low-dose chemotherapy, one patient received all-trans retinoic acid (ATRA) and one patient only received corticosteroids as induction therapy. Patients received low-dose chemotherapy as induction therapy had a lower complete remission (CR) rate (P=0.041), and more patients in this group received HSCT (P=0.010) than patients received intensive chemotherapy. Patients who delayed chemotherapy in the nonexposed cohort experienced a trend toward a higher mortality rate than patients who received timely chemotherapy (P=0.191). The CR (P = 0.488), OS (P=0.655), and DFS (P=0.453) were similar between the exposed and nonexposed cohorts. Overall, the 4-year overall survival (OS) and disease-free survival (DFS) rates were estimated at 49.1% and 57.8%, respectively. All newborns were living, without deformities, or developmental and intellectual disabilities. Our study indicated that P-AL patients in the first trimester might tend to receive chemotherapy after abortion. Both the status of disease and patients\u2019 willingness should be taken into consideration when clinicians were planning treatment strategies in the second or third trimester. Low-dose or delayed chemotherapy might decrease the efficacy of induction therapy and survival rate of patients, but HSCT could improve the prognosis.<\/jats:p>","DOI":"10.3389\/fonc.2021.803994","type":"journal-article","created":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T09:45:30Z","timestamp":1639475130000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Maternal and Fetal Outcomes of Acute Leukemia in Pregnancy: A Retrospective Study of 52 Patients"],"prefix":"10.3389","volume":"11","author":[{"given":"Peng","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenqi","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luwei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shijia","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhong","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Depei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2018.01.009","article-title":"Haematological Cancers in Pregnancy","volume":"379","author":"Brenner","year":"2012","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61727-9","article-title":"Acute Myeloid Leukaemia in Adults","volume":"381","author":"Ferrara","year":"2013","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)35087-3","article-title":"Advanced Reproductive Age and Fertility","volume":"33","author":"Liu","year":"2011","journal-title":"J Obstet Gynaecol Can"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1159\/000486228","article-title":"Incidence, Survival, and Risk Factors for Adults With Acute Myeloid Leukemia Not Otherwise Specified and Acute Myeloid Leukemia With Recurrent Genetic Abnormalities: Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database, 2001-2013","volume":"139","author":"Song","year":"2018","journal-title":"Acta Haematol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2008.03.006","article-title":"How I Treat Acute and Chronic Leukemia in Pregnancy","volume":"22","author":"Shapira","year":"2008","journal-title":"Blood Rev"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21137","article-title":"Acute Leukemia During Pregnancy: A Report on 37 Patients and a Review of the Literature","volume":"104","author":"Chelghoum","year":"2005","journal-title":"Cancer"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(04)01466-4","article-title":"Iacobucci a. Use of Chemotherapy During Human Pregnancy","volume":"5","author":"Cardonick","year":"2004","journal-title":"Lancet Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3816\/clm.2001.n.023","article-title":"Hematological Malignancies and Pregnancy: A Final Report of 84 Children Who Received Chemotherapy In Utero","volume":"2","author":"Aviles","year":"2001","journal-title":"Clin Lymphoma"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-03-643544","article-title":"The 2016 Revision to the World Health Organization Classification of Myeloid Neoplasms and Acute Leukemia","volume":"127","author":"Arber","year":"2016","journal-title":"Blood"},{"key":"B10","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.bmhimx.2016.07.008","article-title":"Ages and Stages Questionnaire: A Global Screening Scale","volume":"74","author":"Singha","year":"2017","journal-title":"Bol Med Hosp Infant Mex"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2011.02517.x","article-title":"Comparison of the Bayley II Mental Developmental Index and the Bayley III Cognitive Scale: Are We Measuring the Same Thing","volume":"101","author":"Lowe","year":"2012","journal-title":"Acta Paediatr"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1097\/DBP.0b013e31819f1c3e","article-title":"Developmental Screening and Assessment: What are We Thinking","volume":"30","author":"Aylward","year":"2009","journal-title":"J Dev Behav Pediatr"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2017.1347651","article-title":"Acute Myeloid Leukemia During Pregnancy: A Systematic Review and Meta-Analysis","volume":"59","author":"Horowitz","year":"2018","journal-title":"Leuk Lymphoma"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2016.1222379","article-title":"Acute Leukemia in Pregnancy: a Single Institution Experience With 23 Patients.","volume":"58","author":"Farhadfar","year":"2017","journal-title":"Leuk Lymphoma"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.hemonc.2014.03.001","article-title":"Leukemia During Pregnancy: Long Term Follow Up of 32 Cases From a Single Institution","volume":"7","author":"Saleh","year":"2014","journal-title":"Hematol Oncol Stem Cell Ther"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1134\/S0006297916120099","article-title":"Molecular and Cellular Interactions Between Mother and Fetus. Pregnancy as a Rejuvenating Factor","volume":"81","author":"Popkov","year":"2016","journal-title":"Biochem (Moscow)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.93.2.705","article-title":"Male Fetal Progenitor Cells Persist in Maternal Blood for as Long as 27 Years Postpartum","volume":"93","author":"Bianchi","year":"1996","journal-title":"Proc Natl Acad Sci U S A"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3109\/10428190109060347","article-title":"Acute Leukemia During Pregnancy: A Single Institutional Experience With 17 Cases","volume":"41","author":"Greenlund","year":"2001","journal-title":"Leuk Lymphoma"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/s0029-7844(98)00282-8","article-title":"Burkitt Lymphoma in Pregnancy","volume":"92","author":"Barnes","year":"1998","journal-title":"Obstet Gynecol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdj053","article-title":"Long Term Evaluation of Cardiac Function in Children Who Received Anthracyclines During Pregnancy","volume":"17","author":"Aviles","year":"2006","journal-title":"Ann Oncol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-03-378919","article-title":"How I Treat Newly Diagnosed Chronic Phase CML","volume":"120","author":"Cortes","year":"2012","journal-title":"Blood"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-015-2372-5","article-title":"Maternal and Fetal Outcomes in Pregnant Women With Acute Promyelocytic Leukemia","volume":"94","author":"Sanz","year":"2015","journal-title":"Ann Hematol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2015.1065977","article-title":"Acute Promyelocytic Leukemia During Pregnancy: A Systematic Analysis of Outcome","volume":"57","author":"Verma","year":"2016","journal-title":"Leuk Lymphoma"},{"key":"B24","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1080\/10937409809524552","article-title":"Developmental and Reproductive Toxicity of Inorganic Arsenic: Animal Studies and Human Concerns","volume":"1","author":"Golub","year":"1998","journal-title":"J Toxicol Environ Health B Crit Rev"},{"key":"B25","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.critrevonc.2016.05.006","article-title":"Management of Hemopoietic Neoplasias During Pregnancy","volume":"104","author":"Payday","year":"2016","journal-title":"Crit Rev Oncol Hematol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1586\/14737140.4.5.889","article-title":"Impact and Treatment of Cancer During Pregnancy","volume":"4","author":"Weisz","year":"2004","journal-title":"Expert Rev Anticancer Ther"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-016-2078-2","article-title":"Fetal Outcome in Pregnancy With Acute Promyelocytic Leukemia","volume":"83","author":"Naithani","year":"2016","journal-title":"Indian J Pediatr"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2005.10.014","article-title":"Cancer and Pregnancy: Poena Magna, Not Anymore","volume":"42","author":"Pentheroudakis","year":"2006","journal-title":"Eur J Cancer"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/7.4.384","article-title":"Cancer in Pregnancy: Maternal and Fetal Implications","volume":"7","author":"Weisz","year":"2001","journal-title":"Hum Reprod Update"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2019.1663818","article-title":"Pregnancy Outcomes Among Leukemia Survivors: A Population-Based Study on 14.5 Million Births","volume":"34","author":"Nolan","year":"2021","journal-title":"J\u00a0Matern Fetal Neonatal Med"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/s0889-8545(05)70011-5","article-title":"Lymphoma and Leukemia Complicating Pregnancy","volume":"25","author":"Peleg","year":"1998","journal-title":"Obstet Gynecol Clin North Am"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1054\/bjoc.2001.2090","article-title":"Neurodevelopment of Children Exposed In Utero to Treatment of Maternal Malignancy","volume":"85","author":"Nulman","year":"2001","journal-title":"Br J Cancer"},{"key":"B33","unstructured":"Pregnancy Complicated With Acute Leukemia: An Eight-Year Retrospective Study of Maternal and Fetal Outcomes\n            WangP\n          2021"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2021.803994\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T09:45:35Z","timestamp":1639475135000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2021.803994\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,14]]},"references-count":33,"alternative-id":["10.3389\/fonc.2021.803994"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2021.803994","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,14]]},"article-number":"803994"}}