Pregnancy outcome of two patients treated with imatinib

Prabhash, Kumar; Sastry, P. S. R. K.; Biswas, Ghanshyam; Bakshi, Ashish; Prasad, Narayan; Menon, Hari; Pm, Parikh

doi:10.1093/annonc/mdi398

Cited by 37 publications

(10 citation statements)

References 4 publications

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“…Yet, despite the counseling, at least 44 pregnancies have been reported. [4][5][6][7][8][9][10] A systematic search of Medline and Biosis databases from 1966 to 2006 using the terms imatinib mesylate, gleevec, glivec, STI571, pregnancy, gestation, placenta, umbilical cord blood and breast milk indicate that this is the first report of imatinib and CGP74588 concentrations in maternal blood, breast milk, umbilical cord blood and placenta.…”

Section: Introductionmentioning

confidence: 87%

Imatinib mesylate and metabolite concentrations in maternal blood, umbilical cord blood, placenta and breast milk

et al. 2007

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Treatment of maternal chronic myeloid leukemia with imatinib mesylate is avoided because of potential fetal effects. Two women with progression of disease during pregnancy required imatinib therapy. Concentrations of imatinib in maternal blood, placenta, umbilical cord blood and breast milk were 886, 2452, 0 to 157, and 596 ng/ml, respectively. Concentrations of the active metabolite CGP74588 in maternal blood, placenta, umbilical cord blood and breast milk were 338, 1462, 0 and 1513 ng/ml, respectively. As Imatinib and CGP74588 cross the mature placenta poorly, use of the drug after the first trimester may be reasonable under some circumstances. Imatinib and CGP74588 are found in breast milk, and therefore avoidance of breastfeeding is advisable.

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Section: Introductionmentioning

confidence: 87%

Imatinib mesylate and metabolite concentrations in maternal blood, umbilical cord blood, placenta and breast milk

et al. 2007

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“…Some reports in literature indicate that patients who receive imatinib at the time of conception may have normal pregnancies. [67][68][69][70][71][72][73][74] Dasatinib and nilotinib are known to cause embryonic or fetal toxicities in animals. Isolated reports can be found in the literature regarding the outcome of pregnancy in patients receiving dasatinib [75][76][77] or nilotinib.…”

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confidence: 99%

Chronic Myelogenous Leukemia, Version 1.2015

O’Brien

Radich

Abboud

et al. 2014

J Natl Compr Canc Netw

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OverviewChronic myelogenous leukemia (CML) accounts for 15% of adult leukemias. The median age at disease onset is 67 years; however, SEER statistics show that CML occurs in all age groups. 1 In 2014, an estimated 5980 people will be diagnosed with CML in the United States, and 810 people will die from the disease. CML is characterized by the presence of Philadelphia chromosome (Ph) resulting from a reciprocal translocation between chromosomes 9 and 22 [t(9;22)]. This translocation, t(9;22), results in the head-to-tail fusion of the breakpoint cluster region (BCR) gene on chromosome 22 at band q11 and the Abelson murine leukemia (ABL1) gene located on chromosome 9 at band AbstractChronic myelogenous leukemia (CML) is usually diagnosed in the chronic phase. Untreated chronic phase CML will eventually progress to advanced phase (accelerated or blast phase) CML. Tyrosine kinase inhibitors (TKIs) have been shown to induce favorable response rates in patients with accelerated and blast phase CML. The addition of TKIs to chemotherapy has also been associated with improved outcomes in patients with blast phase CML. Allogeneic hematopoietic stem cell transplant remains a potentially curative option for patients with advanced phase CML, although treatment with a course of TKIs will be beneficial as a bridge to transplant. This manuscript discusses the recommendations outlined in the NCCN Guidelines for the diagnosis and management of patients with advanced phase CML. (J Natl Compr Canc Netw 2014;12:1590-1610 NCCN Categories of Evidence and ConsensusCategory 1: Based upon high-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2A: Based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2B: Based upon lower-level evidence, there is NCCN consensus that the intervention is appropriate. Category 3: Based upon any level of evidence, there is major NCCN disagreement that the intervention is appropriate. © National Comprehensive Cancer Network, Inc. 2014, All rights reserved. The NCCN Guidelines and the illustrations herein may not be reproduced in any form without the express written permission of NCCN. Disclosures for the NCCN Chronic Myelogenous Leukemia PanelAt the beginning of each NCCN Guidelines panel meeting, panel members review all potential conflicts of interest. NCCN, in keeping with its commitment to public transparency, publishes these disclosures for panel members, staff, and NCCN itself.Individual disclosures for the NCCN Chronic Myelogenous Leukemia Panel members can be found on page 1610. (The most recent version of these guidelines and accompanying disclosures are available on the NCCN Web site at NCCN.org.)These guidelines are also available on the Internet. For the latest update, visit NCCN.org. q34. 3 The product of the BCR-ABL1 fusion gene, p210, which is a fusion protein with deregulated tyrosine kinase activity, plays a central role in the pathogenesis of CML. Another fusion protein, p190, is also produc...

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“…In these 29 pregnancies, the risk of reported spontaneous abortion (8 cases), fatal outcome (1 case with meningocele) or development of fetal abnormalities (2 cases of hypospadias) reached 38 % [3][4][5]8 . In two of the four patients treated with IM during the whole pregnancy, delivery of low-weight children was reported 3,9 . Many more pregnancies during IM therapy have been reported recently 16 .…”

Section: Discussionmentioning

confidence: 99%

“…In animal studies in rats but not rabbits, however, IM exerts potential teratogenicity and, consequently, contraception has been strongly recommended in all women with childbearing potential during IM therapy 1 . Occasional cases of conception or successful pregnancy during IM treatment have however been reported in the literature, mostly as case reports [2][3][4][5][6][7][8][9][10] . In two of the four reported cases treated with IM for the whole duration of pregnancy, delivery of low-weight children were found 3,9 .…”

Section: Successful Childbirth In a Patient With Chronic Myelogenous mentioning

confidence: 99%

Successful Childbirth in a Patient With Chronic Myelogenous Leukemia Treated With Imatinib Mesylate During Early Pregnancy

Skoumalova

Vondráková²,

Rosenberger³

et al. 2008

BIOMED PAP

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Aims:To report a case of successful pregnancy in a patient with chronic myelogenous leukemia treated with imatinib mesylate for the fi rst 4 months of pregnancy.Results: Imatinib mesylate is potentially teratogenic and its use during pregnancy in humans can lead to abortion or development of fetal abnormalities in nearly 40% of fully reported cases. We report a case of a 28-year-old woman who delivered a healthy child of normal weight after having been treated with imatinib for Ph1-positive CML during the fi rst four months of her pregnancy. She refused advocated interruption and for the rest of the pregnancy was treated with interferon. The treatment was associated with a rapid 2-log increase in the leukemia clone measured by the real-time polymerase chain reaction. Reintroduction of imatinib after delivery resulted in achievement of the complete cytogenetic response again.Conclusions: We discuss possible strategies for successful management of pregnancy in CML patients treated with imatinib.

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Pregnancy outcome of two patients treated with imatinib

Cited by 37 publications

References 4 publications

Imatinib mesylate and metabolite concentrations in maternal blood, umbilical cord blood, placenta and breast milk

Imatinib mesylate and metabolite concentrations in maternal blood, umbilical cord blood, placenta and breast milk

Chronic Myelogenous Leukemia, Version 1.2015

Successful Childbirth in a Patient With Chronic Myelogenous Leukemia Treated With Imatinib Mesylate During Early Pregnancy

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