Leukemia in pregnancy.

Validated data from which conclusions may be drawn about the management of leukemia during pregnancy are sparse. Cytotoxic agents should generally be avoided during the first trimester, when there is an approximately 17% chance of fetal malformation, particularly with folate antagonists. However, acute leukemias demand prompt institution of cytotoxic chemotherapy to maximize the chances of maternal survival. Treatment beyond the first trimester is generally safe if appropriate monitoring and obstetric care are available. Treatment of chronic leukemias can usually be delayed until delivery without compromising maternal health. Treatment of leukemia during pregnancy does not appear to have a significant impact on the future growth and development of the child.