An evaluation of the effect of pregnancy on chronic granulocytic leukemia

Sheehy, Thomas W.

doi:10.1016/0002-9378(58)90659-8

Cited by 23 publications

(7 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For women presenting in chronic phase, there is no requirement for elective termination, although some women may request this procedure given their personal circumstances and the uncertainty of their future. It is reassuring for both patient and physician to note that pregnancy itself does not appear to affect the natural course of CML [47].…”

Section: Management Of the Patient Presenting In Pregnancymentioning

confidence: 96%

Managing pregnancy in chronic myeloid leukaemia

2015

View full text Add to dashboard Cite

Over the past decade, we have witnessed significant advances in knowledge of the biology and treatment of chronic myeloid leukaemia (CML). The development of molecular-targeted therapy with tyrosine kinase inhibitors (TKIs) has fundamentally changed the outcome of this disease. Treatment with TKIs is now the standard of care in patients with CML and has dramatically improved long-term survival in the majority of patients. Patients who achieve major molecular response (MMR) after 2 years of treatment with imatinib have survival rates comparable to those of the general population. The success of TKIs has led to durable molecular response and possibility of normal life expectancies, such that it is now timely to address quality of life aspects such as fertility, pregnancy and family planning. Pregnancy in CML presents specific management and therapeutic challenges for the patient and the physician. Despite the recent treatment advances, we still have limited data on the safety of TKIs in pregnancy and its effect on fertility. However, there is a cause for concern and heightened awareness following the occurrence of a constellation of rare congenital malformations and spontaneous abortions in association with imatinib therapy. When a patient becomes pregnant whilst receiving TKI therapy, the difficulty lies in balancing the risk to the foetus of continuing therapy versus the risk to the patient of treatment interruption and potentially losing optimal disease response. All couples should be counselled on the risks associated with pregnancy whilst receiving TKI therapy. This is an essential aspect in patient care and frequently not emphasized enough by physicians. At the time of diagnosis, fertility preservation should be discussed with both male and female patients of childbearing potential. They should be made aware of fertility options which are available such as semen cryopreservation, ovarian or oocyte retrieval and storage and embryo cryopreservation in view of the potential detrimental effect of TKIs on fertility and gonadal function. The recommendation given to patients planning pregnancy differs according to their disease response to TKI therapy, which is the most important prognostic factor in CML.

show abstract

Section: Management Of the Patient Presenting In Pregnancymentioning

confidence: 96%

Managing pregnancy in chronic myeloid leukaemia

2015

View full text Add to dashboard Cite

show abstract

“…First of all it must be considered that CML does not alter the course of pregnancy nor the pregnancy the course of CML [45]. For this reason women presenting in CP must be carefully evaluated and not necessarily addressed to elective termination even if at the beginning of their pregnancy.…”

Section: Diagnosed During Pregnancymentioning

confidence: 99%

Management of pregnant chronic myeloid leukemia patients

Abruzzese

Trawinska

Fabritiis

et al. 2016

Expert Review of Hematology

View full text Add to dashboard Cite

Data published and informations acquired in terms of fertility, conception, pregnancy, pregnancy outcome and illness control for all the approved TKIs will be reviewed, as well as suggest how to manage a planned and/or unplanned pregnancy/conception. Literature search methodology included examination of PubMed index, meeting presentations, and updated Investigator's brochures and data files of TKIs companies. Expert commentary: Male patients trying to conceive apparently have no limitation in the use of TKIs, while effective contraception should be encouraged in all female patients due to the risk of fetal complications after drug exposure. In a female patient pregnancy should be planned and TKI therapy discontinued, while individual risks need to be considered when an unplanned pregnancy occurs.

show abstract

“…There was no evidence from these or from previously published cases (Sheehy, 1958) that pregnancy adversely influences the course of chronic myeloid leukaemia. The optimal treatment of patients with chronic myeloid leukaemia in the chronic phase remains controversial but there is no compelling reason for treating asymptomatic patients, who typically have blood counts < 100 x 109/1 (Goldman 1986a).…”

Section: Discussionmentioning

confidence: 45%

Management of chronic myeloid leukaemia in pregnancy

Arthur

Mijović

Dannie

et al. 1991

Journal of Obstetrics and Gynaecology

View full text Add to dashboard Cite

We studied six pregnancies occurring in four patients with chronic myeloid leukaemia, diagnosed before pregnancy in one case and during the first pregnancy in three cases. For one patient the first pregnancy ended in spontaneous abortion but a second pregnancy, during which she was treated only by leucapheresis, was essentially uneventful although the baby was born with spina bifida and a small meningomyelocele and talipes. A second patient delivered a normal baby after treatment by leucapheresis alone during pregnancy. A third patient was treated with hydroxyurea from 16 weeks in her first pregnancy and with leucapheresis and hydroxyurea during the second pregnancy. Both babies were normal. A fourth patient was treated with busulphan in the third trimester of pregnancy and subsequently by leucapheresis immediately before delivery of a normal baby. Pregnancy may proceed normally in patients with chronic myeloid leukaemia; leucapheresis may be advisable in the first or second trimester but cytotoxic drugs can usually be administered in the later stages of pregnancy without undue risk to the fetus.

show abstract

An evaluation of the effect of pregnancy on chronic granulocytic leukemia

Cited by 23 publications

References 36 publications

Managing pregnancy in chronic myeloid leukaemia

Managing pregnancy in chronic myeloid leukaemia

Management of pregnant chronic myeloid leukemia patients

Management of chronic myeloid leukaemia in pregnancy

Contact Info

Product

Resources

About