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Tokpinar A, Nisari M, Yilmaz S, Yay A, Yildiz OG, Balcioğlu E, Alişan P, Bilgici P, Uçar S, Ateş Ş, Bağci K. The effect of ionizing radiation on the fetal bone development in pregnant rats: Role of melatonin. Microsc Res Tech 2024; 87:95-104. [PMID: 37705325 DOI: 10.1002/jemt.24414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/10/2023] [Accepted: 08/26/2023] [Indexed: 09/15/2023]
Abstract
Radiation has been widely used in many business sectors over the last century. Our study investigated the possible teratogenic effects of radiation on the bones of rat fetuses and the protective effect of melatonin against these effects. In this study, 15 pregnant female Wistar albino rats were used. These rats were divided into four groups: the control group, melatonin group (10 mg/kg/day), radiation group (0.5 gray), radiation (0.5 gray) + melatonin group (10 mg/kg/day), and sham group (1 mm hanks/day). The skeletal system development of fetuses was examined with double skeletal and scanning electron microscope (SEM), histopathological methods. In our study, fetal weight, placental weight, and fetal morphometric values were found to be statistically significantly decreased in the radiation group compared to the control group (p < .05). In immünohistochemistry (IHC) analysis, alkaline phosphatase, and tartrate-resistant acid phosphatase) concentrations were found to be significantly lower in the radiation group compared to the other groups. In the SEM analysis, it was observed that the amount of calcium and sodium decreased when the radiation group was compared with the other groups. As a result, when exposed to ionizing radiation during pregnancy, melatonin has a protective feature against the negative effects of radiation on the bone development of fetuses. RESEARCH HIGHLIGHTS: In our study, fetuses obtained from pregnant rats exposed to ionizing radiation were examined. In this study, the effect of melatonin on bone development in fetuses exposed to gray ionizing radiation was investigated. There are few studies on our subject in the literature. We believe that our findings will contribute to other planned studies.
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Affiliation(s)
- Adem Tokpinar
- Department of Anatomy, Ordu University Faculty of Medicine, Ordu, Turkey
| | - Mehtap Nisari
- Department of Anatomy, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Seher Yilmaz
- Department of Anatomy, Yozgat Bozok University Faculty of Medicine, Yozgat, Turkey
| | - Arzu Yay
- Department of Embryology, Erciyes University Medicine Faculty Histology, Kayseri, Turkey
| | - Oğuz Galip Yildiz
- Department of Radiation Oncology, Erciyes University Medicine Faculty, Kayseri, Turkey
| | - Esra Balcioğlu
- Department of Embryology, Erciyes University Medicine Faculty Histology, Kayseri, Turkey
| | - Pınar Alişan
- Department of Embryology, Erciyes University Medicine Faculty Histology, Kayseri, Turkey
| | - Pınar Bilgici
- Department of Embryology, Erciyes University Medicine Faculty Histology, Kayseri, Turkey
| | - Sümeyye Uçar
- Department of Anatomy, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Şükrü Ateş
- Department of Anatomy, Yozgat Bozok University Faculty of Medicine, Yozgat, Turkey
| | - Kezban Bağci
- Niğde Zübeyde Hanım Vocational School of Health Services, Niğde Ömer Halisdemir University, Niğde, Turkey
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Wang P, Yang Z, Shan M, Lu S, Zhang L, Li S, Hu S, Tian H, Xu Y, Wu D. Maternal and Fetal Outcomes of Acute Leukemia in Pregnancy: A Retrospective Study of 52 Patients. Front Oncol 2022; 11:803994. [PMID: 34970499 PMCID: PMC8712699 DOI: 10.3389/fonc.2021.803994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/26/2021] [Indexed: 12/02/2022] Open
Abstract
Acute leukemia during pregnancy (P-AL) is a rare disease with limited data regarding the management and outcomes of mothers and fetuses. We retrospectively analyzed the characteristics, pregnancy outcomes and maternal and neonatal prognoses of 52 patients with P-AL collected from January 2013 to December 2020 in our center. Seventeen (32.7%) patients received chemotherapy during pregnancy (exposed cohort), while 35 (67.3%) received chemotherapy after abortion/delivery (nonexposed cohort). Twenty-six (50.0%) pregnancies ended with abortion, and 26 (50.0%) babies were born through spontaneous delivery or cesarean section. Seven infants (26.9%) were born in the exposed cohort, while 19 infants (73.1%) were born in the nonexposed cohort. Fetuses in the exposed cohort had lower gestational ages (P=0.030) and birth weights (P=0.049). Considering the safety of the fetus, seven patients in the exposed cohort received low-dose chemotherapy, one patient received all-trans retinoic acid (ATRA) and one patient only received corticosteroids as induction therapy. Patients received low-dose chemotherapy as induction therapy had a lower complete remission (CR) rate (P=0.041), and more patients in this group received HSCT (P=0.010) than patients received intensive chemotherapy. Patients who delayed chemotherapy in the nonexposed cohort experienced a trend toward a higher mortality rate than patients who received timely chemotherapy (P=0.191). The CR (P = 0.488), OS (P=0.655), and DFS (P=0.453) were similar between the exposed and nonexposed cohorts. Overall, the 4-year overall survival (OS) and disease-free survival (DFS) rates were estimated at 49.1% and 57.8%, respectively. All newborns were living, without deformities, or developmental and intellectual disabilities. Our study indicated that P-AL patients in the first trimester might tend to receive chemotherapy after abortion. Both the status of disease and patients’ willingness should be taken into consideration when clinicians were planning treatment strategies in the second or third trimester. Low-dose or delayed chemotherapy might decrease the efficacy of induction therapy and survival rate of patients, but HSCT could improve the prognosis.
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Affiliation(s)
- Peng Wang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhen Yang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Meng Shan
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shenqi Lu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Luwei Zhang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shijia Li
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuhong Hu
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Hong Tian
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yang Xu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Depei Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
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Fries C, Noronha SA, Metlay L, Zhang B. Transplacental transfer of congenital B-cell acute lymphoblastic leukemia to the maternal vasculature. Pediatr Blood Cancer 2021; 68:e29142. [PMID: 34125471 DOI: 10.1002/pbc.29142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Carol Fries
- Department of Pediatrics, Hematology and Oncology, University of Rochester Medical Center, Rochester, New York, USA
| | - Suzie A Noronha
- Department of Pediatrics, Hematology and Oncology, University of Rochester Medical Center, Rochester, New York, USA
| | - Leon Metlay
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Bin Zhang
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, USA.,Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, USA
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Wang HF, Liang MY, Jiang Q. [Management of patients with lymphoma in pregnancy]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2021; 41:1053-1056. [PMID: 33445860 PMCID: PMC7840544 DOI: 10.3760/cma.j.issn.0253-2727.2020.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- H F Wang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China
| | - M Y Liang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - Q Jiang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China
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Kwiatkowski J, Kuliszkiewicz-Janus M, Potoczek S, Jaźwiec B, Wróbel T, Małecki R. What factors determine the pregnancy outcome in patients with essential thrombocythemia? J Matern Fetal Neonatal Med 2021; 35:4734-4738. [PMID: 33792458 DOI: 10.1080/14767058.2020.1863362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: Treatment of essential thrombocythemia (ET) is particularly challenging in pregnancy due to the increased risk of thromboembolic complications. Therefore, the use of antithrombotic regimens are recommended in pregnant women with ET.Methods: The study included 52 pregnancies in 27 patients diagnosed with ET, who were treated in Department of Haematology. The influence of anticoagulant, antiplatelet and cytoreductive therapy on the course and outcome of pregnancy was analysed. This study also examined if there was any correlation between molecular and clinical features such as mutational profile, blood count, presence of acquired von Willebrand syndrome (AvWS), the International Prognostic Score for Essential Thrombocythemia (IPSET) risk group and the IPSET-thrombosis risk group and pregnancy outcome.Results: Study participants who received antithrombotic therapy were significantly more likely to give birth to a healthy child. The best outcomes were observed in patients who received low dose acetylsalicylic acid (ASA) together with low-molecular-weight heparin (LMWH). There was a statistically significant correlation between classification to the high-risk group according to the IPSET-thrombosis score and incidence of miscarriage. Cytoreductive treatment with interferon-α2, as well as the presence of AvWS did not increase the likelihood of pregnancy loss. Blood counts and presence of specific gene mutations profile were also not found to be significant determinants of pregnancy outcome.Conclusion: To our best knowledge, this is the first clinical study investigating the correlation between risk group (according to IPSET and IPSET-thrombosis) and pregnancy outcome in women with ET.
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Affiliation(s)
- Jacek Kwiatkowski
- Department and Clinic of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland
| | | | - Stanisław Potoczek
- Department and Clinic of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland
| | - Bożena Jaźwiec
- Department and Clinic of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland
| | - Tomasz Wróbel
- Department and Clinic of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland
| | - Rafał Małecki
- Department and Clinic of Angiology, Hypertension, and Diabetology, Wroclaw Medical University, Wrocław, Poland
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Li YW, Xu YF, Hu W, Qian SX, Chen C. Acute myeloid leukemia during pregnancy: a single institutional experience with 17 patients and literature review. Int J Hematol 2020; 112:487-495. [PMID: 32683599 DOI: 10.1007/s12185-020-02938-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/16/2020] [Accepted: 06/23/2020] [Indexed: 11/30/2022]
Abstract
Management of acute myeloid leukemia during pregnancy (P-AML) is a challenging endeavor with limited evidence-based information available. To truly achieve the goal of improving P-AML patients, additional evidence-based research is necessary. We retrospectively reviewed cases of 17 patients diagnosed with P-AML, including seven for acute promyelocytic leukemia (APL) from January 2012 to June 2019. Among the non-APL, 90% patients (9/10) ended pregnancy prior to induction chemotherapy. The median intervals between diagnosis and start of chemotherapy were 5 days (range 1-14 days). Four patients elected to delay chemotherapy by more than one week. Of the seven APL patients, six received all-trans retinoic acid (ATRA) before the diagnostic molecular results. Five patients underwent cesarean sections (CS) and all newborns were alive (four preterm and one full-term deliveries). Overall, approximately 94% of the patients (16/17) are currently alive in remission. To treat P-AML patients in a safer manner, balancing the risk of progressing to advanced disease and proceeding with pregnancy is required. We consider a slight delay (less than 14 days) in the termination of pregnancy may not differ the prognosis to patients with non-APL. For APL, patients will benefit from prompt administration of ATRA for highly suspected cases.
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Affiliation(s)
- Yi-Wei Li
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 216 Huansha Road, Hangzhou, Zhejiang, 310006, People's Republic of China.,Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Yang-Feng Xu
- Department of Obstetrics, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, HangZhou, People's Republic of China
| | - Wei Hu
- Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Shen-Xian Qian
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 216 Huansha Road, Hangzhou, Zhejiang, 310006, People's Republic of China.
| | - Can Chen
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 216 Huansha Road, Hangzhou, Zhejiang, 310006, People's Republic of China.
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Garg A, Aggarwal M, Kashyap R. Pregnancy and Its Successful Outcome in a Patient with Multiple Myeloma. J Obstet Gynaecol India 2020; 71:78-81. [PMID: 33814803 DOI: 10.1007/s13224-019-01296-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/04/2019] [Indexed: 11/28/2022] Open
Abstract
Multiple myeloma is a B-cell neoplastic disorder and represents 1% of all cancers and 13% of hematological malignancies. It is predominantly a disease of elderly, and less than 3% of all cases are below the age of 40 years. We present the case of a 29-year-old lady with multiple myeloma who had spontaneous conception during maintenance therapy and subsequently a successful pregnancy outcome. She gave birth to a healthy female infant through normal vaginal delivery and subsequently could remain off therapy for 5 years. Since the patient had a history of abortions and stillbirth, it was a precious pregnancy and we could successfully salvage both the mother and the baby. Young female patients of myeloma who are in remission can be encouraged to start a family during their reproductive years with the support of a comprehensive care team of hematologists/oncologists and obstetricians.
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Affiliation(s)
- Akanksha Garg
- Department of Hematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014 India
| | - Monika Aggarwal
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, 110001 India
| | - Rajesh Kashyap
- Department of Hematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014 India
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Maruyama S, Sato Y, Moriuchi K, Kanbayashi S, Ri Y, Taga A, Emoto I, Kim T. Fetal death following idarubicin treatment for acute promyelocytic leukemia in pregnancy-A case report. Eur J Obstet Gynecol Reprod Biol 2017; 218:140. [PMID: 28987888 DOI: 10.1016/j.ejogrb.2017.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 09/01/2017] [Accepted: 09/23/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Shunsuke Maruyama
- Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu 520-8511, Shiga, Japan
| | - Yukiyasu Sato
- Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu 520-8511, Shiga, Japan.
| | - Kaori Moriuchi
- Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu 520-8511, Shiga, Japan
| | - Shota Kanbayashi
- Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu 520-8511, Shiga, Japan
| | - Yasufumi Ri
- Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu 520-8511, Shiga, Japan
| | - Atsuko Taga
- Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu 520-8511, Shiga, Japan
| | - Ikuko Emoto
- Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu 520-8511, Shiga, Japan
| | - Tomoko Kim
- Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu 520-8511, Shiga, Japan
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