Successful management of acute promyelocytic leukemia in the third trimester of pregnancy: a case report and review of the literature

Acute promyelocytic leukemia (APL) during pregnancy is an exceptionally rare occurrence with high maternal and fetal mortality rates, requiring a highly tailored approach to therapy. We report a case of a patient diagnosed with APL during the third trimester of pregnancy who initially presented with...

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Main Authors: Sirichai Puttirangsan, B. Prasertkanchana, Natnipa Parapob, Sirichai Srichairatanakool, Thanawat Rattanathammethee
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Hematology
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Online Access:https://www.frontiersin.org/articles/10.3389/frhem.2025.1553336/full
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author Sirichai Puttirangsan
B. Prasertkanchana
Natnipa Parapob
Sirichai Srichairatanakool
Thanawat Rattanathammethee
author_facet Sirichai Puttirangsan
B. Prasertkanchana
Natnipa Parapob
Sirichai Srichairatanakool
Thanawat Rattanathammethee
author_sort Sirichai Puttirangsan
collection DOAJ
description Acute promyelocytic leukemia (APL) during pregnancy is an exceptionally rare occurrence with high maternal and fetal mortality rates, requiring a highly tailored approach to therapy. We report a case of a patient diagnosed with APL during the third trimester of pregnancy who initially presented with spontaneous ecchymoses. Treatment was initiated with all-trans retinoic acid (ATRA) and a modified dose of idarubicin, leading to a rapid correction of the coagulopathy and a complete remission of the APL. The patient subsequently underwent induced labor, resulting in an uncomplicated vaginal delivery without significant hemorrhage and no evidence of embryopathy in the neonate. To date, no published reports of successful deliveries in patients with APL have been documented in Thailand. This case highlights how a multidisciplinary approach involving obstetricians, hematologists, and neonatologists ensured both maternal survival and optimal neonatal outcomes.
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publisher Frontiers Media S.A.
record_format Article
series Frontiers in Hematology
spelling doaj-art-bc3a12e03ecc401ca229a08be7d40a052025-08-20T02:35:56ZengFrontiers Media S.A.Frontiers in Hematology2813-39352025-06-01410.3389/frhem.2025.15533361553336Successful management of acute promyelocytic leukemia in the third trimester of pregnancy: a case report and review of the literatureSirichai Puttirangsan0B. Prasertkanchana1Natnipa Parapob2Sirichai Srichairatanakool3Thanawat Rattanathammethee4Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDivision of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDivision of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDivision of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandAcute promyelocytic leukemia (APL) during pregnancy is an exceptionally rare occurrence with high maternal and fetal mortality rates, requiring a highly tailored approach to therapy. We report a case of a patient diagnosed with APL during the third trimester of pregnancy who initially presented with spontaneous ecchymoses. Treatment was initiated with all-trans retinoic acid (ATRA) and a modified dose of idarubicin, leading to a rapid correction of the coagulopathy and a complete remission of the APL. The patient subsequently underwent induced labor, resulting in an uncomplicated vaginal delivery without significant hemorrhage and no evidence of embryopathy in the neonate. To date, no published reports of successful deliveries in patients with APL have been documented in Thailand. This case highlights how a multidisciplinary approach involving obstetricians, hematologists, and neonatologists ensured both maternal survival and optimal neonatal outcomes.https://www.frontiersin.org/articles/10.3389/frhem.2025.1553336/fullacute promyelocytic leukemiapregnancythird trimestermultidisciplinary approachesperinatal care
spellingShingle Sirichai Puttirangsan
B. Prasertkanchana
Natnipa Parapob
Sirichai Srichairatanakool
Thanawat Rattanathammethee
Successful management of acute promyelocytic leukemia in the third trimester of pregnancy: a case report and review of the literature
Frontiers in Hematology
acute promyelocytic leukemia
pregnancy
third trimester
multidisciplinary approaches
perinatal care
title Successful management of acute promyelocytic leukemia in the third trimester of pregnancy: a case report and review of the literature
title_full Successful management of acute promyelocytic leukemia in the third trimester of pregnancy: a case report and review of the literature
title_fullStr Successful management of acute promyelocytic leukemia in the third trimester of pregnancy: a case report and review of the literature
title_full_unstemmed Successful management of acute promyelocytic leukemia in the third trimester of pregnancy: a case report and review of the literature
title_short Successful management of acute promyelocytic leukemia in the third trimester of pregnancy: a case report and review of the literature
title_sort successful management of acute promyelocytic leukemia in the third trimester of pregnancy a case report and review of the literature
topic acute promyelocytic leukemia
pregnancy
third trimester
multidisciplinary approaches
perinatal care
url https://www.frontiersin.org/articles/10.3389/frhem.2025.1553336/full
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