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The incidence is not well established and only based on rare case reports.97,98 A recent systematic review included 53 reports of individual cases, among which 92 patients were eligible for induction therapy, either with ATRA (32 %), ATRA and anthracycline (43 %), or anthracycline only;98 the CR rate was 89 %.98,99 Besides the increased risk of maternal and fetal death, intrauterine growth restriction, and malformations are additional risks when APL and pregnancy coexist so that the discussion needs to be discussed by the patient, family, and the medical multidisciplinary team.6,7,97,98 Medical termination of pregnancy is usually contraindicated upon diagnosis due to pancytopenia and coagulopathy, which are not controlled at that moment.6,7 If APL is diagnosed in the first trimester, therapeutic options are quite limited, and the risk of miscarriage is higher compared to the second or third trimesters (88 % versus 30 %).98 Although specific information regarding the teratogenicity of ATRA is not available, this effect is well demonstrated with other retinoids6 and, therefore, it should be avoided in the first trimester