Anesthesia consideration for cesarean section in chronic myeloid leukemia diagnosed during pregnancy: An interesting case report and brief review of literature

Chronic myeloid leukemia (CML) is a myeloproliferative disorder with clonal expansion of transformed primitive hematopoietic progenitor cells without loss of their capacity to differentiate. Annual incidence of CML in females ranges from 0.6 to 1.6 per 100,000 populations. In developing countries like India where onset of hematological malignancy occurs in early age, thereby increases chances of concomitant occurrence of CML and pregnancy together. Although the incidence is rare, anesthesia management of pregnant female presenting more so for an emergency cesarean section (C/S) is challenging because of the physiological changes during pregnancy, presence of anemia, coagulopathy, immunosuppressant drugs, leukocytosis, and rarely blast cells in circulation. We report the successful management of a 19-year-old primigravida, recently diagnosed with CML, planned for emergency C/S under general anesthesia in view of meconium-stained liquor with fetal distress.