Anesthetic Management of Two Pregnant Patients With Chronic Myeloid Leukemia: Two Case Reports.

Anesthetic management of pregnant patients with chronic myeloid leukemia (CML) is complicated by concerns that neuraxial techniques could theoretically introduce leukemic cells into the central nervous system. Evidence guiding anesthetic decisions in chronic-phase CML without circulating blasts is limited. We describe two pregnant patients with CML in whom anesthetic management was individualized based on disease status and obstetric risk. Systemic analgesia was chosen when molecular relapse raised concern for occult blasts, whereas spinal anesthesia was performed in deep molecular remission when maternal comorbidities increased the risk of general anesthesia. Both patients had uncomplicated deliveries, with molecular remission confirmed at 1-year follow-up.