Display options
Cite
Parrott J, Holland M. Undetected Severe Fetal Myelosuppression following Administration of High-Dose Cytarabine for Acute Myeloid Leukemia: Is More Frequent Surveillance Necessary?. Case Rep Obstet Gynecol. 2017;2017:5175629doi: 10.1155/2017/5175629.
Parrott, J., & Holland, M. (2017). Undetected Severe Fetal Myelosuppression following Administration of High-Dose Cytarabine for Acute Myeloid Leukemia: Is More Frequent Surveillance Necessary?. Case reports in obstetrics and gynecology, 20175175629. https://doi.org/10.1155/2017/5175629
Parrott, Jessica, and Holland, Marium. "Undetected Severe Fetal Myelosuppression following Administration of High-Dose Cytarabine for Acute Myeloid Leukemia: Is More Frequent Surveillance Necessary?." Case reports in obstetrics and gynecology vol. 2017 (2017): 5175629. doi: https://doi.org/10.1155/2017/5175629
Parrott J, Holland M. Undetected Severe Fetal Myelosuppression following Administration of High-Dose Cytarabine for Acute Myeloid Leukemia: Is More Frequent Surveillance Necessary?. Case Rep Obstet Gynecol. 2017;2017:5175629. doi: 10.1155/2017/5175629. Epub 2017 Sep 17. PMID: 29075543; PMCID: PMC5623771.
Copy Download .nbib Format: NLM
Share it on

Case Rep Obstet Gynecol. 2017;2017:5175629. doi: 10.1155/2017/5175629. Epub 2017 Sep 17.

Undetected Severe Fetal Myelosuppression following Administration of High-Dose Cytarabine for Acute Myeloid Leukemia: Is More Frequent Surveillance Necessary?.

Case reports in obstetrics and gynecology

Jessica Parrott, Marium Holland

Affiliations

  1. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.

PMID: 29075543 PMCID: PMC5623771 DOI: 10.1155/2017/5175629

Abstract

BACKGROUND: Cytarabine use during pregnancy carries a 5-7% risk of neonatal cytopenia. We report two cases of fetal myelosuppression following high-dose cytarabine administration for acute myeloid leukemia (AML).

CASE 1: A 36-year-old G9P6 diagnosed with AML at 21 weeks was monitored for fetal anemia weekly and growth monthly. At 33 weeks (after 2 cycles), BPP was 2/10 and MCA PSV was elevated at 1.51 MoM. Urgent cesarean section was performed. The infant had an initial pH of 6.78 and pancytopenia (hematocrit 13.3%, platelets 3 K/UL, and white blood cell count 2.0 K/UL). Initially transfusion dependent, the neonate had count recovery by 3 weeks.

CASE 2: A 30-year-old G4P3 with AML at 26 weeks was monitored for fetal anemia twice weekly and growth monthly. At 34 weeks (after cycle 1), she was admitted with neutropenic fever. The fetal MCA PSV was borderline at 1.48 MoM. It improved to 1.38 MoM at 35 weeks but the fetal tracing worsened. At delivery the fetus was found to have a hematocrit of 30%, but with normal platelet and WBC. The fetus did not require any transfusions.

CONCLUSION: Cytarabine use during pregnancy may cause neonatal myelosuppression. We recommend monitoring for fetal anemia with MCA Dopplers twice weekly.

References

  1. Eur J Obstet Gynecol Reprod Biol. 2014 Mar;174:76-9 - PubMed
  2. Br J Haematol. 2015 Aug;170(4):487-95 - PubMed
  3. Lancet Oncol. 2004 May;5(5):283-91 - PubMed
  4. Ann Pharmacother. 2015 Jan;49(1):48-68 - PubMed
  5. Arch Dis Child Fetal Neonatal Ed. 1994 Nov;71(3):F209-10 - PubMed
  6. Eur J Haematol. 2015 Aug;95(2):124-36 - PubMed
  7. J Perinat Med. 2009;37(6):713-4 - PubMed
  8. Gynecol Obstet Invest. 2004;58(4):186-8 - PubMed
  9. Arch Intern Med. 1988 Sep;148(9):2058-64 - PubMed

Publication Types