Pregnancy in a woman with chronic neutrophilic leukemia.

Abstract

Chronic neutrophilic leukemia is a rare myeloproliferative disorder in women of reproductive age. A pregnant woman with an established diagnosis of chronic neutrophilic leukemia presented at 26 weeks of gestation with splenomegaly, thrombocytopenia, leukocytosis, and anemia. Thrombocytopenia was refractory to medical treatment and, in part, was attributed to splenic sequestration. She delivered a healthy neonate at 35 weeks of gestation by repeat cesarean delivery under general anesthesia. Her preoperative platelet count was 30,000/mL and she was transfused platelets throughout the perioperative period. Her postpartum course was complicated by intraabdominal hemorrhage and severe preeclampsia. She recovered with intensive medical and surgical management. Chronic neutrophilic leukemia poses difficult challenges during pregnancy and requires a multidisciplinary approach.