Secondary Acute T-Lymphoblastic Leukemia Following Pregnancy After Remission of Acute Promyelocytic Leukemia: A Case Report with Literature Review.

Acute promyelocytic leukemia (APL) predominantly affects younger patients with significantly prolonged survival. Therefore, controlling the incidence of secondary hematological malignancies represents a crucial therapeutic goal. Secondary, acute T-lymphoblastic leukemia (T-ALL) following APL is rare and confers a poor prognosis, with only 2 cases reported to date. Herein, we present a case of a young female with APL who attained complete remission (CR) after receiving dual induction therapy with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO), followed by standard consolidation and maintenance treatment cycles. After discontinuing chemotherapy for 26 months, the patient conceived naturally and was later diagnosed with T-ALL in the first trimester of pregnancy. She attained a second CR after receiving the VDCLP chemotherapy regimen (vincristine+daunorubicin+cyclophosphamide+L-asparaginase+prednisone). She subsequently underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) and remained in sustained CR at the 18-month follow-up time point. For patients with T-ALL secondary to APL after treatment remission, early diagnosis combined with the VDCLP regimen and allo-HSCT demonstrated certain therapeutic efficacy.