Management of chronic myeloid leukemia during pregnancy: a retrospective analysis at a single center

Abstract

We analyzed the management and outcomes of pregnancies of patients with chronic myeloid leukemia at a single center over fifteen years. Among the 203 CML female patients, there were ten pregnancies in seven women, all of them not planned. In three cases, the chronic myeloid leukemia diagnosis was made during pregnancy. Five patients received tyrosine kinase inhibitors in the first weeks of pregnancy and the drug was interrupted until delivery. One patient lost complete cytogenetic response, and two patients lost the hematological response. A patient with a stable major molecular response had two successful pregnancies without loss of response. There were four premature births. There were no maternal adverse events, fetal malformation or death. All patients received Interferon-alpha during gestation, and two received hydroxyurea for a short period. Leukapheresis was performed in two patients for hyperleukocytosis control. One patient with sickle cell disease died from disease progression six months after delivery. Conclusions The tyrosine kinase inhibitors ministration should be interrupted during pregnancy. Patients should be advised to achieve a stable and deep molecular response if they plan to conceive, to avoid the risk of disease progression.

The effect of imatinib administered in the prenatal period on testis development in rats

“…De Moura et al reported that pregnant patients exposed to TKI in the first weeks of pregnancy exhibited no congenital malformations, but nevertheless recommended that TKI use be avoided during pregnancy. 44 Long-term imatinib use has been observed to cause vascular contraction in the placenta and shrinkage in the trophoblast layer both in rats receiving imatinib during pregnancy and also in rats in which imatinib use was stopped before pregnancy. 45 Normal births have been reported in association with the use of imatinib in the second and third trimesters of pregnancy, with lower concentrations of imatinib being observed in umbilical blood than in maternal blood.…”

Chronic myeloid leukemia management during pregnancy: a case report

“…In general, malignancies during the which are known to have functions that may be important on gonadal development, implantation and fetal development [5][6][7].…”