Fetal Loss in a Patient with Acute Myeloblastic Leukemia Associated with FLAG-IDA Regime

Acute leukemia in pregnancy offers a unique management dilemma in the absence of clear guidelines. There is some transporters localized into the placental trophoblasts plays an important role in limiting the passage of substrate drug. Herein, we reported a case of fetal loss in a pregnant patient in 34 gestational weeks, with acute myeloblastic leukemia who treated with high dose cytarabine plus fludarabine chemotherapy, to discuss the effects of cytotoxic agent on fetus. There were many reports about pregnancies complicated with AML treated with standart dose cytosine arabinoside and antracyclin combination. We suggest that high dose chemotherapy, mainly FLAG-IDA regime may cause fetal death, although in nearby term periods. Understanding the role of drug transporters in moderating transplacental passage of substrates has important clinical implications for choosing specific drugs to achieve therapeutic objectives.