Acute myeloid leukemia (AML) is a rare type of cancer that starts in the bone marrow and typically progresses into the blood. Although this type of leukemia is more common in males and older adults, pregnant people can also develop it.
AML is rare and accounts for about
Although unlikely, a pregnant person can develop AML. This type of cancer accounts for over
This article examines how common AML is during pregnancy, the risk factors, and treatment during the first, second, and third trimesters. It also looks at whether treatment can harm a fetus, the safety of breastfeeding, and the outlook for the cancer.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
AML during pregnancy is rare. It occurs in approximately
Read more about AML.
Anyone can develop AML, but certain risk factors may increase a person’s risk of developing the disease. For pregnant people, these risk factors
- age, as AML risk increases as a person ages
- having certain blood disorders, such as essential thrombocythemia and idiopathic myelofibrosis
- having a genetic syndrome, such as Fanconi anemia, severe congenital neutropenia, and Diamond-Blackfan anemia
- having chemotherapy treatment with chemotherapy medication called alkylating drugs
- being exposed to certain chemicals, such as long-term or heavy exposure to formaldehyde or benzene
- being exposed to radiation, such as radiation treatment for cancer
- having a family history of AML
Read more about risk factors for AML.
Doctors may treat AML in a pregnant person differently from how they would typically treat the disease in someone who is not pregnant. This is because certain common AML treatments
Types of treatment for AML can vary depending on the extent of cancer, the pregnant person’s overall health, their personal preferences, and their pregnancy stage.
Read about the medications and treatments for AML.
Treatment during the first trimester
Treatment for AML during the first trimester of pregnancy is generally difficult.
Because AML progresses
If a pregnant person delays chemotherapy treatment for AML, however, they typically face a
If a person develops AML during the first trimester, a doctor may discuss options to terminate the pregnancy. Delaying treatment could severely affect the health of the pregnant person and the fetus.
Read a guide to pregnancy trimesters.
Treatment during the second and third trimesters
Researchers have found that it is
Doctors do not generally recommend chemotherapy for people who are 35 weeks or more into pregnancy or within 3 weeks of delivery, as it may lower the blood cell counts of the pregnant person and fetus. This could result in bleeding and an increased risk of infection.
Doctors may treat certain cancers in pregnant people with radiation, but typically avoid its use at all stages of pregnancy. This is because it could harm the fetus and increase the risks of congenital anomalies, childhood cancer, slow growth, pregnancy loss, or stillbirth.
Read about AML complications.
AML and its treatments can potentially harm a fetus. AML can
Chemotherapy is the main treatment for AML. Doctors consider chemotherapy generally safe for a fetus during the second and third trimesters of pregnancy. However, in the first trimester, chemotherapy can be harmful to a fetus and
- fetal death
- pregnancy loss
- congenital anomalies
- slow fetal growth
In some cases, people have reported fetal health problems from exposure to chemotherapy in the second and third trimesters. These include:
- reduced fertility
- intellectual impairment
- restricted growth
A person should discuss with their doctor when it may be safe to start breastfeeding after they have completed their treatments. This may be months after their treatment ends.
The outlook for a pregnant person with AML can vary depending on various factors. These include:
- the trimester of pregnancy a person is in when they receive a diagnosis
- the extent of the AML
- the personal preferences and choices a pregnant person with AML makes
- the age and general health of the pregnant person
AML in pregnant people is rare, and
The 5-year net survival for people with AML ages 15–44 years old is 62%. For people ages 45–54 years old, it is 42%.
Although AML is the most common type of leukemia in adults and the most common leukemia affecting pregnant people, it is a rare cancer. Pregnant people are not at high risk of developing AML.
AML progresses quickly and can have severe health effects. Doctors typically begin chemotherapy treatment as soon as possible after AML diagnosis to improve a person’s outlook.
However, chemotherapy during the first trimester of pregnancy can harm a fetus. Doctors may discuss pregnancy termination if a person has AML in the first trimester. This is to avoid risking the person’s health and the fetus’ health by delaying treatment.
Doctors consider chemotherapy during the second and third trimesters of pregnancy to be generally safe.