Pregnancy and Acute Lymphoblastic Leukemia: A Case Series and Review of Literature
Bibliographic record
Abstract
Abstract Acute lymphoblastic leukemia (ALL) diagnosed during pregnancy is rare and causes ethical and therapeutic challenges. We performed a retrospective search of ALL patients (n = 202) treated at our institution from 2015 to 2020 and found five patients diagnosed during pregnancy. In this report, we discuss the individual patients in detail and the challenges faced during their treatment. The use of established lymphoblastic leukemia treatment protocols and the modifications made therein to prevent untoward chemotherapy-related toxicities to the fetus are discussed in this study. We report the second use of rasburicase during pregnancy in literature with favorable maternal and fetal outcomes. We also present an extensive literature review of 41 cases of ALL in pregnancy previously reported. It is important to note that there is a dearth of guidelines for the treatment of these complex situations, and although certain general principles can be established, an individualized approach is needed in most cases of leukemia diagnosed during pregnancy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".