SUCCESSFUL PREGNANCY AND DELIVERY IN CHRONIC MYELOID LEUKEMIA

Chronic Myeloid Leukemia most commonly presents in older age group with median age of diagnosis at 65yrs. Occurrence of Chronic Myeloid Leukemia in pregnancy is very rare -1 in 75,000 to 1 lakh pregnancies. While CML may not need to be treated immediately, and pregnancy does not appear to affect the course of CML, there is still a risk of leukostasis, as well as the risk of placental insufficiency with consequent below normal fetal birth weight , increased fetal prematurity and increased mortality if CML is left untreated for the duration of the pregnancy. The management of CML during pregnancy is challenging because of the potential effects of the therapy on the mother and fetus. A 23yr old G2P1Lo known case of Chronic Myeloid Leukemia in chronic phase on Imatinib, came to our hospital at 35 days of amenorrhea. Imatinib was stopped and she was put on Interferon alpha till 36wks. At 36 wks her total WBC count increased to 74,400 cellsmm3 with Interferon alpha. So she was again switched over to Imatinib. Labor was induced at 36wks and she delivered an alive girl baby of 2.04 kg weight without any congenital anomalies. Placenta and membranes were sent for histopathological examination but fortunately did not show any metastatis. This case is presented because of its rarity and to highlight that Alpha interferon is a safer therapeutic option is pregnancy with CML.