Successful treatment of acute promyelocytic leukaemia with all-trans-retinoic-acid during late pregnancy

Abstract

We describe a patient with acute promyelocytic leukaemia (PML) diagnosed in the third trimester of pregnancy who presented with coagulopathy and prolonged bleeding time. Treatment with all-trans-retinoic-acid (ATRA) resulted in rapid normalization of the coagulopathy and complete remission of PML within 2 weeks. Induced labour resulted in an uneventful vaginal delivery without major blood loss with no signs of neonatal ATRA-induced embryopathy. ATRA therapy for PML during late pregnancy was effective in reversing the maternal bleeding tendency and inducing a complete remission of the PML without evidence of teratogenicity. Careful monitoring of bleeding time is important, even after normalization of clotting parameters and thrombocyte count, for determining the moment of induction of labour.