Fortis Hospital Bannerghatta Road in Bengaluru delivered exceptional multidisciplinary care in a rare and life-threatening case by successfully treating a 32-year-old woman from Kenya diagnosed with high-risk Acute Promyelocytic Leukaemia (APL) - a rare and aggressive form of blood cancer, accounting for only one-tenth of acute myeloid leukaemia cases, reported in mere 0.08 individuals per 100,000 population. APL poses profound risks due to bleeding, clotting abnormalities and rapid progression, and its occurrence during pregnancy is infrequent and medically complex.
At just 15 weeks of pregnancy, the patient faced the dual challenge of early gestation and an aggressive hematologic malignancy - a rare and high-risk combination known to cause severe bleeding, disseminated clotting, organ failure, and significant maternal and fetal complications.
The aggressive nature of APL, coupled with the physiological demands of pregnancy, made timely diagnosis and rapid initiation of treatment critical to safeguarding her life and stabilising the pregnancy.
The patient arrived at Fortis Hospital, Bannerghatta Road, with persistent fatigue, unexplained bleeding, and severe pain in her right leg. A detailed clinical assessment revealed high-risk Acute Promyelocytic Leukemia (APL) - a rare and aggressive form of Blood Cancer marked by profound coagulopathy (Inability of the blood to clot) and deep vein thrombosis (DVT).
Abnormal fluid accumulation around the heart and lungs, liver abnormalities, and a painful uterine fibroid further complicated her clinical course. Each of these life-threatening issues required immediate and coordinated intervention from a multidisciplinary team comprising haematology, vascular surgery, cardiopulmonary medicine, and obstetrics to stabilise her condition and initiate urgent treatment.
The patient was started on two internationally established therapeutic agents that form the foundation of standard APL induction therapy, aimed at achieving rapid and effective remission. Over the subsequent six weeks, she received this treatment under intensive monitoring to promptly detect and manage any cardiac, pulmonary, hematologic, or metabolic complications that can arise during therapy.
Simultaneously, she received comprehensive supportive care tailored to her complex clinical condition. This included broad-spectrum antibiotics, anticoagulant therapy, regular blood and platelet transfusions, and ongoing collaborative management by specialists across disciplines.
This multidisciplinary, protocol-driven approach was pivotal in controlling infections, preventing bleeding, and supporting organ systems throughout the intense treatment phase. Following nearly six weeks of induction therapy, she was subsequently discharged in stable condition with a detailed post-treatment care and follow-up plan to ensure continued monitoring and long-term disease control.
Giving details of the case, Dr Niti Raizada, Principal Director – Medical Oncology & Hemato-Oncology, Fortis Hospital, Bannerghatta Road, said, “Acute Promyelocytic Leukaemia is one of the most aggressive but also one of the most curable forms of leukaemia when treated promptly. In this case, the patient presented with high-risk disease, pregnancy-related complications and extensive Deep Vein Thrombosis, which made her condition extremely critical. Early diagnosis, timely initiation of systemic therapy along with blood products and chemo tablets and coordinated multidisciplinary care helped us achieve complete remission.”
Dr Madhusudan N, Senior Consultant – Radiation Oncology, Fortis Hospital, Bannerghatta Road, added, “APL requires vigilant monitoring as patients can develop severe bleeding, clotting abnormalities, electrolyte imbalances, and cardiac issues during therapy. Our team ensured continuous management with specialists across cardiology, pulmonology, vascular surgery, and gynaecology. The patient responded exceptionally well during treatment.”
Dr Nishit Ojha, Consultant – Hemato Oncology, Fortis Hospital, Bannerghatta Road, added, “Managing high-risk APL during pregnancy is extremely delicate, as treatment must balance the safety of both mother and unborn child. In this case, every decision was taken with minute-to-minute vigilance. The patient’s excellent response reflects the importance of precise risk stratification, protocol-driven therapy, and constant multidisciplinary monitoring.”
Expressing her gratitude, the patient said, “When I arrived in India, I was very unwell and fearful for my life and my baby. The team at Fortis supported me with compassion and clarity. They guided me at every step and made me feel safe. Being discharged today in good health is a blessing I never expected.”
Dr Thejaswini Parthasarathy, Facility Director, Fortis Hospital, Bannerghatta Road, said, “This case highlights the strength of multidisciplinary cancer care at Fortis Hospital, Bannerghatta Road. Treating high-risk leukaemia in a pregnant patient with multiple organ complications requires advanced clinical expertise and seamless coordination. We are proud of our team’s efforts in delivering safe, evidence-based care to ensure a positive outcome.”