Combination chemotherapy with conservative obstetric management in the treatment of pregnant patients with acute myeloblastic leukaemia.

We have reviewed the management of pregnant women presenting with acute myeloblastic leukaemia (AML) at the London Hospital since 1972. Six women in the second or third trimester were diagnosed with AML over this period. One woman had termination of pregnancy at presentation in the second trimester. Three of the remaining five patients achieved complete remission following chemotherapy during pregnancy. Delivery was achieved by the vaginal route in three and by caesarean section in one patient. All were livebirths but one infant had Down's syndrome. Median maternal survival was 16 months (range 0-44 months). Long-term survival was achieved for both mother and infant in only one case. Longer maternal survival was seen in patients treated in the period 1980-1985. Increased survival appears to be related to the introduction of more aggressive chemotherapy schedules and improved supportive care.