A case of acute myeloid leukemia during pregnancy presenting
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"Introduction: The incidence of pregnancy associated leukemia is approximately one in 75,000 to 100,000 pregnancies. The majority of leukemias diagnosed during pregnancy are acute. Of these acute leukemias, two-thirds are myeloid. Early and prompt diagnosis is challenging, hence unspecific symptoms such as fatigue, dyspnea or weakness are easily attributed to the physiological changes during pregnancy.

Case Report: A case of a 33 weeks pregnant female, presenting with abdominal pain. During an emergency cesarean section performed for fetal distress, the appendix presented swollen and an appendectomy was performed. The diagnosis of acute leukemia was made, based on the laboratory findings showing thrombocytopenia, anemia and leukocytosis with a high percentage of circulating blasts in the peripheral blood. Microscopy of the appendix showed inflammation with an abnormal infiltration of blasts. The patient was referred to a tertiary center and treated for acute myeloid leukemia (AML). She died due to relapse 16 months after the initial diagnosis.

Conclusion: AML during pregnancy is rare. Appendicitis being its first presentation is very uncommon. After taking care of initial concerns regarding the fetal well-being, chemotherapeutic treatment has to be commenced as soon as possible, in order to obtain the best chances of survival for the mother."....