What is leukaemia?
This is simply known as cancer of the blood. In actual fact, it is a cancerous proliferation of the cells in the bone marrow, which gives rise to the different types of blood cells in circulation.
The cancerous cells in the marrow spill over into the circulation.
Acute leukaemia is the aggressive form of the disease which can become very serious in a matter of days and, without treatment, can kill the patient in two or three months. There will be a severe deficiency of red blood cells, white blood cells and platelets. As mentioned, untreated, death ensues within about three months.
Chronic leukaemia is slowly progressive and may go on for years, even without treatment.
How common is leukaemia in pregnancy?
Acute leukaemia is a disease of the younger age groups. In fact, of cancer-related deaths in the reproductive age group (sixteen to forty years), acute leukaemia is the second most common!
In absolute terms, however, it remains rare. The incidence is about one in 75,000 pregnancies. An average district hospital will encounter one pregnant woman with leukaemia once every twenty years or so.
Does pregnancy make leukaemia more likely to occur?
Does pregnancy have an adverse effect on the course (progression) of leukaemia?
In an oblique way, yes. Pregnancy itself will not affect the course of the disease. However, it may actually cause a delay in diagnosis, which could be critical. At the outset, the symptoms of acute leukaemia include non-specific clinical features such as fatigue and breathlessness. These are not uncommon in uncomplicated pregnancy.
A routine blood test at an early stage may reveal anaemia as the only abnormality. Again, this is not uncommon in pregnancy and all the symptoms may be put down to this. The unsuspecting doctor may then send the expectant mother away with a prescription of iron supplements and dietary advice. This can be catastrophic, because a delay of a few days in diagnosis could actually mean the difference between life and death for both the mother and the baby.
Once diagnosed, how is acute leukaemia treated?
There are different types of acute leukaemia and treatment will partly depend on this. Generally speaking, treatment is by combination chemotherapy and the response on the whole is good. This is in the short and medium term.
There is usually a period of maintenance therapy, once the condition has gone into remission.
Relapse is not uncommon and tends to occur within two to five years.