New York Woman, 33, Diagnosed With Leukemia 29 Weeks Into Second Pregnancy After Complaining Of Fatigue

Recounting her cancer journey to Staten Island Live, she said her diagnosis came after she informed her obstetrician about her abnormal amount of fatigue, requesting additional blood testing.

After noting how it was hard to get an appointment to get additional testing, due to doctors thinking her case wasn’t “serious,” she was diagnosed with AML and told she needed treatment immediately.

Acute Myeloid Leukemia (AML): Overview

Shortly after, she was. taken to Weill Cornell Medicine/NewYork-Presbyterian Medical Center in Manhattan where she underwent induction therapy, followed by five-and-a-half weeks of IV chemotherapy treatments.

With the support of her mom, husband, and 7-year-old daughter, she powered through treatment and was medically induced into labor at 34 weeks pregnant, and gave birth to her son Maximo Justin Trunzo on April 28.

Her son was born premature, needing to stay in the hospital’s Neonatal Intensive Care Unit, because he had fetal growth restriction (FGR), a condition that caused him to grow slower or smaller than normal.

Trunzo was able to return home with her newborn on May 9th, after another round of chemotherapy. After rounds of chemo and blood transfusions, the mom of two is now in remission, and still needing additional rounds of chemotherapy, but thankful she was able to discover she had AML when she did.

She told SILIVE, “They [doctors] said it would have gone undetected had I not been pregnant.

“Because they did such routine bloodwork when I was pregnant, they were able to pick it up as quickly as they did.”

A GoFundMe has since been set up for Trunzo to help her with “any medical expenses, specialized treatments, and living and child care costs as she battles this devastating disease while protecting her unborn child,” and has raised nearly $50,000.

The GoFundMe reads, “Yelena, a devoted nurse, loving wife, exceptional daughter, super star mom to daughter Adrianna, and soon-to-be mommy of 2, has spent years caring for patients with unwavering compassion.

“She and her family were overjoyed to learn she was finally expecting another baby. But their joy was short-lived as she was recently diagnosed with a rare and aggressive form of Acute Myeloid Leukemia (AML) in her 7th month of pregnancy on a routine follow doctors visit and rushed to Cornell Medical Center straight after work on 3/21/24.”

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It continues, “Now, instead of preparing for the arrival of her little one, she is facing the fight of her life and the life of her unborn child. This type of AML requires immediate and intensive treatment, including chemotherapy, bone marrow transplant, and long hospital stays, the current stay being one that is lasting into premature delivery and a minimum 6 week stay.

“She is currently receiving double dose chemo (7+3 regiment) while still carrying her baby BOY! This has placed an enormous emotional and financial strain on her family as she will be unable to return to work for at least 4 months and will not receive any paid assistance until baby is delivered and even then will have enormous new expenses for travel for her family to visit, medical bills of those not covered by insurance and newly acquired expenses such as diapers and formula all while unable to return to work until all medical treatments are complete and full remission is achieved.”

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Understanding Acute Myeloid Leukemia

Acute myeloid leukemia is a fast-growing blood cancer that begins in the bone marrow, the factory that makes white and red blood cells and platelets.

Within the bone marrow are stem cells that eventually develop into white blood cells (WBCs), red blood cells (RBCs), and platelets, which help blood clot.

Stem cells can copy themselves to make progenitor cells or precursor cells. Myeloid progenitor cells turn into red blood cells, granulocytes (a type of white blood cell), and platelets. AML affects the myeloid progenitor cells during a stage of development when they are called myeloblasts.

With AML, myeloblasts fail to turn into fully developed blood cells, leaving them to build up in the bone marrow and blood.

WATCH: An AML Diagnosis What are the Next Steps?

AML is diagnosed by extracting samples of liquid bone marrow and a chip of bone from the back of the hip. The samples are then tested to determine if blood cells in the bone marrow are abnormal.

Dr. Gail Roboz, an AML expert and medical oncologist at Weill Cornell Medicine, says, “The majority of patients have this sporadically out of the clear blue sky.”

Symptoms for acute myeloid leukemia can include:

• Flu-like symptoms
• Fatigue
• Fever
• Loss of appetite

AML causes certain symptoms, but having these symptoms doesn’t necessarily mean you have AML. Your doctor will do diagnostic tests to confirm whether you have AML before recommending a treatment.

The symptoms of AML can be subtle, says Dr. Mikkael Sekeres

Your doctor will then perform tests to diagnose you, and those tests include:

• Blood tests. In people with AML, white blood cell counts may be high, and red blood cell and platelet counts may be low. These tests can also show immature cells in the blood that should only be found in the bone marrow.
• Bone marrow biopsy. Removing and testing a bone marrow sample helps confirm  AML after an abnormal blood test result.
• Lumbar puncture. This test uses a sample of spinal fluid to diagnose AML.
• Molecular and genetic testing. Your doctor can do tests to determine whether you have certain genes related to AML and if your cancer might respond to specialized treatments.

Treating AML

For people deemed healthy enough, induction therapy is the standard treatment for AML. The process involves a seven-day chemotherapy regimen, followed by several weeks of recovery. The goal of this high dose of chemo is to induce remission.

WATCH: More on AML Treatment Options

A stem cell transplant is another option for treating AML, as Winsor opted to pursue. After a high dose of chemotherapy, a stem cell transplant gives the patient healthy cells to replace the ones that chemotherapy may have killed.

After chemo and a transplant, the recovery process can be difficult for the patient because the immune system will be compromised. Finding a genetic match in a donor may also be an arduous process.

Clinical trials may offer treatment options. Ask your doctor if any therapies under investigation might be appropriate for you.

The effects of leukemia treatment are very individualized. Treatment may get rid of all leukemia cells for some people, while others will have to remain on chemotherapy long-term to control their cancer. Expect to have follow-up exams after treatment, usually every month to begin with and then at longer intervals.

Even though AML cancer warriors may complete treatment, there is always the chance of a relapse. The timing of the relapse plays a significant role in which treatment route your doctor will advise.

“Unfortunately for many patients with AML, their disease will come back, and we call that a disease relapse,” says Dr. Tara Lin, director of the Acute Leukemia Program at the University of Kansas Medical Center.

“It’s really important that when a patient has a relapse of their disease, they see someone who has a lot of experience in treating AML.”

Cancer During Pregnancy

The American Cancer Society says in addition to breast cancer, other types of cancer pregnant women may experience include:

• Melanoma
• Leukemia
• Cervical cancer
• Thyroid cancer
• Ovarian cancer
• Colon cancer
• Lymphoma

Remember, during pregnancy, the body undergoes several changes making cancer-related changes harder to detect. Still, some things to be watchful for include:

• Hormone levels change during pregnancy, which causes breasts to become larger, lumpy, and/or tender.
• Rectal bleeding could possibly be due to benign hemorrhoids, a common occurrence during pregnancy, or from colon or rectal cancer.
• Feeling tired could be from pregnancy weight gain or from low red blood cell counts (anemia), which can be seen in leukemias and lymphomas or during pregnancy.
• As the fetus and uterus grow throughout pregnancy, ovarian tumors get more difficult to detect.

Staying current on all of your health and cancer-related screenings will help you manage your cancer risk.

How Cancer Treatments Impact Fertility

Chemotherapy can destroy eggs in your ovaries. This can make it impossible or difficult to get pregnant later. Whether or not chemotherapy makes you infertile depends on the drug type and age since your egg supply decreases with age.

“The risk is greater the older you are,” reproductive endocrinologist Dr. Jaime Knopman previously told SurvivorNet.

“If you’re 39 and you get chemo that’s toxic to the ovaries, it’s most likely to make you menopausal. But, if you’re 29, your ovaries may recover because they have a higher baseline supply,” Dr. Knopman continued.

Radiation to the pelvis can also destroy eggs. It can damage the uterus, too. Surgery to your ovaries or uterus can hurt fertility as well.

Meanwhile, endocrine or hormone therapy may block or suppress essential fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment.

If you have a treatment that includes infertility as a possible side effect, your doctor won’t be able to tell you whether you will have this side effect. That’s why you should discuss your options for fertility preservation before starting treatment.

WATCH: How chemotherapy affects fertility.

Research shows that women who have fertility preserved before breast cancer treatment are more than twice as likely to give birth after treatment than those who don’t take fertility-preserving measures.

Most women preserve their fertility before cancer treatment by freezing their eggs or embryos.

After you finish your cancer treatment, a doctor specializing in reproductive medicine can implant one or more embryos in your uterus or the uterus of a surrogate with the hope that it will result in pregnancy.

If you freeze eggs only before treatment, a fertility specialist can use sperm and eggs to create embryos in vitro and transfer them to your uterus.

When freezing eggs or embryos is not an option, doctors may try these approaches:

• Ovarian tissue freezing is an experimental approach for girls who haven’t yet reached puberty and don’t have mature eggs or for women who must begin treatment immediately and don’t have time to harvest eggs.
• Ovarian suppression prevents the eggs from maturing so they cannot be damaged during treatment.
• For women getting radiation to the pelvis, Ovarian transposition moves the ovaries out of the line of treatment.

In addition to preserving eggs or embryos, positive research has shown that women with early-stage hormone-receptor (HR) positive breast cancer were able to safely pause endocrine therapy (ET) to try to get pregnant, and they did not have worse short-term recurrence rates than people who did not stop endocrine therapy.

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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