{
  "abstract": "Acute leukaemia complicates 1 in 75 000 pregnancies and poses therapeutic challenges due to the teratogenic risks of chemotherapy during organogenesis. We report a case of a woman in her early 30s (adolescent/young adult (AYA) population) at 8 weeks of gestation who presented with fatigue. Peripheral blood smear suggested acute lymphoblastic leukaemia (ALL) and diagnostic tests confirmed pro B-cell type ALL. Medical termination of pregnancy was performed as per the International Federation of Gynaecology and Obstetrics guidelines due to first-trimester teratogenicity risks, followed by intrathecal methotrexate for central nervous system prophylaxis and induction as per the modified Berlin-Frankfurt-Münster regimen, a paediatric-inspired protocol selected for AYA efficacy. She achieved complete remission post-induction, with minimal residual disease <0.01% by flow cytometry and remained on maintenance therapy. This highlights the need for multidisciplinary management, psychological support for fertility and grief counselling. While first-trimester termination minimises fetal risks, continuing pregnancy with the incorporation of safer agents, such as vincristine and corticosteroids, post-organogenesis has yielded positive maternal-fetal outcomes in reported cases.",
  "authors": [
    {
      "affiliations": [
        "Obstetrics and Gynaecology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"
      ],
      "name": "Harshinee Sree Santhanam"
    },
    {
      "affiliations": [
        "Obstetrics and Gynaecology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"
      ],
      "name": "Suprajna Shetty"
    },
    {
      "affiliations": [
        "Obstetrics and Gynaecology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"
      ],
      "name": "Shraddha Shetty"
    },
    {
      "affiliations": [
        "Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"
      ],
      "name": "Sri Devi H B"
    }
  ],
  "title": "‘At the crossroads of creation and cure’: leukaemia in pregnancy",
  "uid": "40718d0c-4f9c-5965-9853-f55126bc1ff9"
}