急性白血病合并妊娠15例临床分析

A CLINICAL ANALYSIS OF 15 CASES OF ACUTE LEUKEMIA COMPLICATING PREGNANCY

报道１５例急性白血病合并妊娠，分析不同孕期接受化学治疗对孕妇及胎儿的影响。早孕期发病者，化疗对胎儿有不利影响，而在中晚孕期发病者，化疗对胎儿（以及出生后）影响较小，但对孕妇本身，愈早治疗才有可能取得较好的预后。因此，推荐早孕期发病者即作人工流产术，术后进行联合化疗及充分的支持疗法；中晚孕期发病者不需中止妊娠，强调在较好的支持疗法的同时，进行联合化疗。

o explore the rationaI treatment program for acute leukenua complicating pregnancy, we carried out aretrospective study of 1 5 cases of acute leukemia complicating pregnancy and treated with chemotherapy from 1973 to 1993 in the Hematology Ward of PUMC. Review of the cases receiving chemotherapy re- vealed no harm to the children in cases of late onset and poor prognosis for the children in cases of early on- set.However,the overall resuits seemed to indicate that the earlier the chemotherapy was instituted,the better the outcome will be for the mothers. A protocol is thus proposed with emphasis on the timing of in-stitution of chemotherapy in relation to the course of pregnancy.Briefly,induced abortion followed by combined chemotherapy in early pregnsncy and timely combined chemotherapy in mid-and late recommended.Brief cessation of chemotherapy during parturition may be necessary and sufficient sup- portive measures are needed.