{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:26:31Z","timestamp":1778595991219,"version":"3.51.4"},"reference-count":74,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: The occurrence of acute myeloid leukemia (AML) in pregnancy represents a diagnostic and management challenge in the attempt to balance and achieve both maternal and fetal wellbeing. Pregnancy-specific manifestations mimic the initial symptoms of leukemia and may lead to a delay in diagnosis, especially during the first trimester of pregnancy. Decision-making strategies involve the patient and couples counseling with a multidisciplinary team of hematologists, obstetricians, neonatologists and psychologists. Maternal outcome depends on the disease subtype, progression and response to medication. Fetal outcome depends on other potential pregnancy complications, possible teratogenicity, gestational age at delivery and sometimes iatrogenic prematurity. Case Presentation: We present the case of a 38-year-old multiparous patient with a late first trimester, with an AML diagnosis presenting with hyperemesis gravidarum-like symptoms. Genetic testing revealed the presence of an Fms-like tyrosine kinase 3-internal tandem duplication mutation (FLT3-ITD). Following that, a repeatedly refused termination of pregnancy and rapid disease progression with azacitidine therapy was initiated. Elective cesarean delivery was performed at 34 weeks of gestation due to progressive leukocytosis, which persisted postpartum, requiring the use of first-, second-, and eventually third-line chemotherapy. Fetal outcome was favorable at 3 months postpartum. Conclusions: Cases of AML in pregnancy require a tailored approach according to guidelines, but also patient\/couple preferences, while the choice of chemotherapy is limited considering its potential teratogenic effects. This is a case with a misleading first presentation and a challenging therapeutic choice due to its genetic subtype and maternal treatment postponement.<\/jats:p>","DOI":"10.3390\/diagnostics15192540","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T09:41:02Z","timestamp":1760002862000},"page":"2540","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An Account of Acute Myeloid Leukemia Complicating Pregnancy and Literature Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8567-1246","authenticated-orcid":false,"given":"Georgiana","family":"Nemeti","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology I, Mother and Child Department, University of Medicine and Pharmacy \u201cIuliu Ha\u021bieganu\u201d, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2323-3101","authenticated-orcid":false,"given":"Laura","family":"Jimbu","sequence":"additional","affiliation":[{"name":"Department of Haematology, Ion Chiricuta Oncology Institute, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oana","family":"Mesaros","sequence":"additional","affiliation":[{"name":"Department of Haematology, Ion Chiricuta Oncology Institute, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6106-816X","authenticated-orcid":false,"given":"Iulian Gabriel","family":"Goidescu","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology I, Mother and Child Department, University of Medicine and Pharmacy \u201cIuliu Ha\u021bieganu\u201d, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3939-8199","authenticated-orcid":false,"given":"Cezara","family":"Moisa","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy \u201cIuliu Ha\u021bieganu\u201d, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4922-3013","authenticated-orcid":false,"given":"Mihai","family":"Surcel","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology I, Mother and Child Department, University of Medicine and Pharmacy \u201cIuliu Ha\u021bieganu\u201d, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cerasela Mihaela","family":"Goidescu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Clinic I\u2014Internal Medicine, Cardiology and Gastroenterology, University of Medicine and Pharmacy \u201cIuliu Ha\u021bieganu\u201d, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Boitor-Borza","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology I, Mother and Child Department, University of Medicine and Pharmacy \u201cIuliu Ha\u021bieganu\u201d, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gheorghe","family":"Cruciat","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology I, Mother and Child Department, University of Medicine and Pharmacy \u201cIuliu Ha\u021bieganu\u201d, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7700-2384","authenticated-orcid":false,"given":"Ioana Cristina","family":"Rotar","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology I, Mother and Child Department, University of Medicine and Pharmacy \u201cIuliu Ha\u021bieganu\u201d, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Muresan","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology I, Mother and Child Department, University of Medicine and Pharmacy \u201cIuliu Ha\u021bieganu\u201d, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fracchiolla, N.S., Scium\u00e8, M., Dambrosi, F., Guidotti, F., Ossola, M.W., Chidini, G., Gianelli, U., Merlo, D., and Cortelezzi, A. (2017). Acute myeloid leukemia and pregnancy: Clinical experience from a single center and a review of the literature. BMC Cancer, 17.","DOI":"10.1186\/s12885-017-3436-9"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"7290","DOI":"10.1080\/14767058.2021.1946788","article-title":"Krukenberg tumor in pregnancy: A rare case and review of the literature","volume":"35","author":"Goidescu","year":"2022","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.ogc.2005.08.008","article-title":"Hematologic malignancies in pregnancy","volume":"32","author":"Hurley","year":"2005","journal-title":"Obstet. Gynecol. Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/S0140-6736(11)61348-2","article-title":"Haematological cancers in pregnancy","volume":"379","author":"Brenner","year":"2012","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1038\/s41375-022-01613-1","article-title":"The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic\/Dendritic Neoplasms","volume":"36","author":"Khoury","year":"2022","journal-title":"Leukemia"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1182\/blood.2022015850","article-title":"International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: Integrating morphologic, clinical, and genomic data","volume":"140","author":"Arber","year":"2022","journal-title":"Blood"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1111\/bjh.13554","article-title":"Guidelines for the diagnosis and management of acute myeloid leukaemia in pregnancy","volume":"170","author":"Ali","year":"2015","journal-title":"Br. J. Haematol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"79","DOI":"10.3892\/mco.2024.2777","article-title":"Leukemia in pregnancy: Diagnosis and therapeutic approach (Review)","volume":"21","author":"Giannakaki","year":"2024","journal-title":"Mol. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e151","DOI":"10.1016\/S2352-3026(24)00309-0","article-title":"Position statement on the diagnosis and management of acute leukaemia and aggressive lymphomas in pregnancy","volume":"12","author":"Mills","year":"2025","journal-title":"Lancet Haematol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1111\/imj.16651","article-title":"Haematological malignancies during pregnancy: A systematic review of necessary services in the Australian context","volume":"55","author":"Cassidy","year":"2025","journal-title":"Intern. Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1182\/blood.2022016867","article-title":"Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN","volume":"140","author":"Wei","year":"2022","journal-title":"Blood"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1182\/blood-2013-08-283580","article-title":"How I treat leukemia during pregnancy","volume":"123","author":"Milojkovic","year":"2014","journal-title":"Blood"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S293","DOI":"10.1016\/S2152-2650(24)01157-1","article-title":"AML-083 AML in Pregnancy: Case Series","volume":"24","author":"Ganju","year":"2024","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_14","first-page":"e43794","article-title":"A Survival Analysis of Acute Myeloid Leukemia Patients Treated with Intensive Chemotherapy: A Single Center Experience","volume":"15","author":"Jimbu","year":"2023","journal-title":"Cureus"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Alrajhi, A.M., Alhazzani, S.A., Alajaji, N.M., Alnajjar, F.H., Alshehry, N.F., and Tailor, I.K. (2019). The use of 5-azacytidine in pregnant patient with Acute Myeloid Leukemia (AML): A case report. BMC Pregnancy Childbirth, 19.","DOI":"10.1186\/s12884-019-2522-1"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2989","DOI":"10.1158\/1078-0432.CCR-21-4525","article-title":"FDA Approval Summary: Oral Azacitidine for Continued Treatment of Adults with Acute Myeloid Leukemia Unable to Complete Intensive Curative Therapy","volume":"28","author":"Jen","year":"2022","journal-title":"Clin. Cancer Res."},{"key":"ref_17","first-page":"126","article-title":"Acute myeloblastic leukemia in pregnancy: A case report and review of the literature","volume":"25","author":"Yucebilgin","year":"2004","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"ref_18","first-page":"144","article-title":"Acute myeloblastic leukaemia in pregnancy\u2014Case reports","volume":"3","author":"Joseph","year":"2006","journal-title":"Highl. Med. Res. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1177\/2040620713492933","article-title":"Acute lymphoblastic leukemia in pregnancy: A case report with literature review","volume":"4","author":"Ticku","year":"2013","journal-title":"Ther. Adv. Hematol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1182\/blood.V122.21.1421.1421","article-title":"Acute Myeloid Leukemia Diagnosed During Pregnancy: Facing Challenges. Systematic Review and Analysis of 174 Reported Cases","volume":"122","author":"Henig","year":"2013","journal-title":"Blood"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3924","DOI":"10.9734\/BJMMR\/2014\/9531","article-title":"Acute Lymphoblastic Leukaemia in Pregnancy: A Case Report","volume":"4","author":"Amiwero","year":"2014","journal-title":"Br. J. Med. Med. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"25","DOI":"10.5348\/Z08-2015-7-CR-7","article-title":"A case of acute myeloid leukemia during pregnancy presenting as acute appendicitis","volume":"1","author":"Boudry","year":"2015","journal-title":"J. Case Rep. Images Obstet. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1052","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":"ref_24","first-page":"5035","article-title":"Acute Myeloid Leukemia in Pregnancy","volume":"130","author":"Seegars","year":"2017","journal-title":"Blood"},{"key":"ref_25","first-page":"53","article-title":"Pregnancy associated acute leukemia: Single center experience","volume":"16","author":"Mabed","year":"2018","journal-title":"Cancer Treat. Res. Commun."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"610","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":"ref_27","first-page":"832","article-title":"Acute myeloid leukemia diagnosed during pregnancy. Case report","volume":"89","year":"2021","journal-title":"Ginecol. Obstet. M\u00e9xico"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1080\/07853890.2021.1908586","article-title":"Acute leukemia in pregnancy: A single institutional experience with 21 cases at 10 years and a review of the literature","volume":"53","author":"Zhu","year":"2021","journal-title":"Ann. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.18203\/2320-1770.ijrcog20221574","article-title":"Acute myelocytic leukemia in pregnancy case report and literature review: A case report","volume":"11","author":"Acosta","year":"2022","journal-title":"Int. J. Reprod. Contracept. Obstet. Gynecol."},{"key":"ref_30","first-page":"4","article-title":"Acute myeloid leukemia in pregnancy: Difficult journey from diagnosis to Delivery and treatment","volume":"1","author":"Kumari","year":"2022","journal-title":"J. Clin. Case Rep. Med. Images Health Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"285","DOI":"10.36348\/sijog.2022.v05i06.001","article-title":"Acute Myeloid Leukemia and Pregnancy about a Case and Review of the Literature","volume":"5","author":"Kriouile","year":"2022","journal-title":"Sch. Int. J. Obstet. Gynecol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s00404-024-07402-8","article-title":"Pregnancy and neonatal outcomes in 25 pregnant women diagnosed with new-onset acute myeloid leukemia during pregnancy","volume":"310","author":"Ding","year":"2024","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_33","unstructured":"Imane, Z., Hajar, E., Leila, E., Mohamed, J., Amine, L., and Said, B. (2024). Acute Myeloblastic Leukemia Discovered in the 3rd Trimester of Pregnancy. J. Case Rep. Med. Hist., 4."},{"key":"ref_34","first-page":"1","article-title":"Acute Myeloblastic Leukaemia and Pregnancy: Case Report","volume":"9","author":"Kawtari","year":"2025","journal-title":"Am. J. Surg. Clin. Case Rep."},{"key":"ref_35","first-page":"147","article-title":"Clinical Analysis and Literature Review of 26 Patients with Hematological Malignancies During Pregnancy","volume":"6","author":"Ma","year":"2025","journal-title":"Womens Health Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1002\/ajh.27625","article-title":"Acute Myeloid Leukemia: 2025 Update on Diagnosis, Risk-Stratification, and Management","volume":"100","author":"Shimony","year":"2025","journal-title":"Am. J. Hematol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1007\/s11864-024-01202-7","article-title":"Emerging DNA Methylome Targets in FLT3-ITD-Positive Acute Myeloid Leukemia: Combination Therapy with Clinically Approved FLT3 Inhibitors","volume":"25","author":"Tecik","year":"2024","journal-title":"Curr. Treat. Options Oncol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1182\/blood.2024025409","article-title":"Genetic risk classification for adults with AML receiving less-intensive therapies: The 2024 ELN recommendations","volume":"144","author":"DiNardo","year":"2024","journal-title":"Blood"},{"key":"ref_39","first-page":"1911","article-title":"Internal tandem duplication of the flt3 gene found in acute myeloid leukemia","volume":"10","author":"Nakao","year":"1996","journal-title":"Leukemia"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1177\/1060028014552516","article-title":"Treatment of acute myeloid leukemia during pregnancy","volume":"49","author":"Chang","year":"2015","journal-title":"Ann. Pharmacother."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1182\/blood-2015-07-604512","article-title":"Epigenetics and approaches to targeted epigenetic therapy in acute myeloid leukemia","volume":"127","author":"Wouters","year":"2016","journal-title":"Blood"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1038\/s41392-019-0095-0","article-title":"Targeting epigenetic regulators for cancer therapy: Mechanisms and advances in clinical trials","volume":"4","author":"Cheng","year":"2019","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e147898","DOI":"10.1172\/JCI147898","article-title":"Germline RUNX1 variation and predisposition to childhood acute lymphoblastic leukemia","volume":"131","author":"Li","year":"2021","journal-title":"J. Clin. Investig."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1038\/s41375-023-01884-2","article-title":"Validation and refinement of the 2022 European LeukemiaNet genetic risk stratification of acute myeloid leukemia","volume":"37","author":"Rausch","year":"2023","journal-title":"Leukemia"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1182\/blood-2016-09-693648","article-title":"How I treat FLT3-mutated AML","volume":"129","author":"Pratz","year":"2017","journal-title":"Blood"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"110","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":"ref_47","unstructured":"U.S. Food and Drug Administration. (2025, August 17). Idamycin\u00ae Idarubicin Hydrochloride for Injection, USP, Available online: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2021\/050661s016lbl.pdf."},{"key":"ref_48","unstructured":"U.S. Food and Drug Administration. (2025, September 01). Cytarabine Injection, Available online: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2020\/071868s032lbl.pdf."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"32","DOI":"10.5045\/br.2022.2022017","article-title":"FLT3 mutations in acute myeloid leukemia: A review focusing on clinically applicable drugs","volume":"57","author":"Ahn","year":"2022","journal-title":"Blood Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e01610","DOI":"10.14309\/crj.0000000000001610","article-title":"Cytarabine-Induced Hyperbilirubinemia in a Pregnant Patient with Acute Myeloid Leukemia","volume":"12","author":"Rajan","year":"2025","journal-title":"ACG Case Rep. J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1177\/10781552241238979","article-title":"Clinical activity, pharmacokinetics, and pharmacodynamics of oral hypomethylating agents for myelodysplastic syndromes\/neoplasms and acute myeloid leukemia: A multidisciplinary review","volume":"30","author":"Haumschild","year":"2024","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1056\/NEJMoa1300874","article-title":"Retinoic Acid and Arsenic Trioxide for Acute Promyelocytic Leukemia","volume":"369","author":"Avvisati","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"101522","DOI":"10.1016\/j.tranon.2022.101522","article-title":"Evolving of treatment paradigms and challenges in acute promyelocytic leukaemia: A real-world analysis of 1105 patients over the last three decades","volume":"25","author":"Sun","year":"2022","journal-title":"Transl. Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Puttirangsan, S., Prasertkanchana, B., Parapob, N., Srichairatanakool, S., and Rattanathammethee, T. (2025). Successful management of acute promyelocytic leukemia in the third trimester of pregnancy: A case report and review of the literature. Front. Hematol., 4.","DOI":"10.3389\/frhem.2025.1553336"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"206","DOI":"10.3892\/etm.2023.11905","article-title":"Pregnant woman with acute promyelocytic leukemia delivers healthy twins and is cured successfully: A case report","volume":"25","author":"Ni","year":"2023","journal-title":"Exp. Ther. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1080\/15384047.2018.1529122","article-title":"New onset acute promyelocytic Leukemia during pregnancy: Report of 2 cases","volume":"20","author":"Li","year":"2019","journal-title":"Cancer Biol. Ther."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s00404-017-4583-6","article-title":"Successful treatment of acute promyelocytic leukemia in pregnancy with single-agent all-trans retinoic acid","volume":"297","author":"Nellessen","year":"2018","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Droc, G., Stancioaica, M.C., Soare, C.G., Stefan, M.-G., Ingustu, D., Martac, C., Coriu, D., Isac, S., Suciu, N., and Andrei, S. (2023). Acute Promyelocytic Leukemia and Severe Differentiation Syndrome in Pregnancy\u2014A Management Challenge. Life, 13.","DOI":"10.3390\/life13051141"},{"key":"ref_59","first-page":"3686584","article-title":"Arsenic Trioxide Treatment during Pregnancy for Acute Promyelocytic Leukemia in a 22-Year-Old Woman","volume":"2020","author":"Cochet","year":"2020","journal-title":"Case Rep. Hematol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"364","DOI":"10.3892\/ol.2015.3190","article-title":"Pregnancy-induced hypertension caused by all-trans retinoic acid treatment in acute promyelocytic leukemia","volume":"10","author":"Song","year":"2015","journal-title":"Oncol. Lett."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"752","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":"ref_62","first-page":"634252","article-title":"A Complicated Case of Acute Promyelocytic Leukemia in the Second Trimester of Pregnancy Successfully Treated with All-trans-Retinoic Acid","volume":"2015","author":"Agarwal","year":"2015","journal-title":"Case Rep. Hematol."},{"key":"ref_63","first-page":"76","article-title":"A Life-Threatening Complication During the Fourth Pregnancy Due to Acute Promyelocytic Leukemia: A Case Report","volume":"56","author":"Sisnawati","year":"2024","journal-title":"Acta Med. Indons."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.1177\/1078155220915764","article-title":"Two successful deliveries of healthy children by a young woman diagnosed and treated during induction and relapsed therapy for acute promyelocytic leukemia","volume":"26","author":"Dang","year":"2020","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Maruyama, S., Sato, Y., Moriuchi, K., Kanbayashi, S., Ri, Y., Taga, A., Emoto, I., and Kim, T. (2017). Fetal death following idarubicin treatment for acute promyelocytic leukemia in pregnancy\u2014A case report. Eur. J. Obstet. Gynecol. Reprod. Biol., 218.","DOI":"10.1016\/j.ejogrb.2017.09.024"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"102476","DOI":"10.1016\/j.bcmd.2020.102476","article-title":"First report of successful management of acute promyelocytic leukemia in a pregnant female with All-Trans-Retinoic Acid and Arsenic Trioxide-based induction regimen","volume":"85","author":"Khosla","year":"2020","journal-title":"Blood Cells Mol. Dis."},{"key":"ref_67","first-page":"94","article-title":"Fatal Intracranial Hemorrhage in a Young Pregnant Patient with Acute Promyelocytic Leukemia","volume":"49","author":"Zhang","year":"2019","journal-title":"Ann. Clin. Lab. Sci."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e262299","DOI":"10.1136\/bcr-2024-262299","article-title":"Second trimester medical abortion in acute promyelocytic leukaemia","volume":"17","author":"Siwatch","year":"2024","journal-title":"BMJ Case Rep."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2283","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. Matern. Fetal Neonatal Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1080\/10428194.2017.1352097","article-title":"Pregnancy and child health outcomes in pediatric and young adult leukemia and lymphoma survivors: A systematic review","volume":"59","author":"Shliakhtsitsava","year":"2018","journal-title":"Leuk. Lymphoma"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.htct.2020.11.004","article-title":"Teratogenic effect of decitabine in a pregnant patient with acute myeloid leukemia: A case report","volume":"44","author":"Lee","year":"2022","journal-title":"Hematol. Transfus. Cell Ther."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Wang, P., Yang, Z., Shan, M., Lu, S., Zhang, L., Li, S., Hu, S., Tian, H., Xu, Y., and Wu, D. (2021). Maternal and Fetal Outcomes of Acute Leukemia in Pregnancy: A Retrospective Study of 52 Patients. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.803994"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1182\/asheducation-2015.1.138","article-title":"Fertility issues in patients with hematologic malignancies","volume":"2015","author":"Loren","year":"2015","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1182\/blood.2018846790","article-title":"Fertility preservation in patients with hematologic malignancies and recipients of hematopoietic cell transplants","volume":"134","author":"Loren","year":"2019","journal-title":"Blood"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/19\/2540\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:50:52Z","timestamp":1760035852000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/19\/2540"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,9]]},"references-count":74,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["diagnostics15192540"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15192540","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,9]]}}}