Tyrosine kinase inhibitors and pregnancy in chronic myeloid leukemia: opinion, evidence, and recommendations

Abruzzese, Elisabetta; Mauro, Michael J.; Apperley, Jane F.; Chelysheva, Ekaterina

doi:10.1177/2040620720966120

Cited by 33 publications

(24 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…NCCN guidelines recommended BCR–ABL levels are measured every 4 week 15 if BCR–ABL transcript levels rise above 1%. Some experts also recommended BCR–ABL levels need to be monitored every 4 weeks during pregnancy, and patients who have an elevated molecular response need frequent testing ( 27 ). If MMR is lost, management is determined by their clinical condition.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Management of Chronic Myeloid Leukemia and Pregnancy: A Bibliometric Analysis (2000-2020)

Wang

Jiang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundGiven the increasing number and survival rates of reproductive-age patients with chronic myeloid leukemia (CML), several studies aimed to elucidate optimum disease management in pregnancy. This study aimed to use bibliometric analysis to assess focus and reported insights, as well as future trends, in CML and pregnancy research.MethodsWe extracted all studies related to CML and pregnancy from the Web of Science database from 2001 to 2020. VOS Viewer, CiteSpace, Python, and R-bibliometrix were used for bibliometric analysis, revealing the leading research countries, institutions, and authors, as well as distribution of keywords (frequency greater than five).ResultsA total of 196 records, published in 137 journals by 1,105 authors from 421 research institutes in 50 countries, were identified for analysis. The United States was the leader in the number of publications. Imperial College London and National Research Center for Hematology were the most influential institutions. In addition, Apperley J, Cortes J, Abruzzese E and Kantarjian H were the leading authors in the field. Keyword analysis identified four research hotspot clusters.ConclusionsThis study systematically analyzed the progress in CML and pregnancy research in the last 20 years. The present findings suggest that the management of planned and unplanned pregnancies in patients with CML will remain a research focus, as further evidence is required for the development of treatment guidelines.

show abstract

Section: Discussionmentioning

confidence: 99%

“…When the risk of pregnancy increases, treatment during pregnancy is beneficial and necessary for both the patient and the fetus. The adverse effects of delayed treatment in pregnant patients have not been clearly reported in the literature, however, a few cases of rapid disease progression and eventual death have been reported ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Management of Chronic Myeloid Leukemia and Pregnancy: A Bibliometric Analysis (2000-2020)

Wang

Jiang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…As pregnancy during TKI consumption is associated with the risk of teratogenicity, it is recommended that young women who wish to become pregnant discontinue TKIs, even if temporarily, from the pre-pregnancy to post-natal period [11,20,45]. To do so, it is necessary to achieve a DMR, which is considered as an eligibility criterion for TKI discontinuation, as soon as possible from the CML diagnosis and aiming for TFR as a therapeutic goal.…”

Section: Patients Who Wish To Be Pregnantmentioning

confidence: 99%

Which Tyrosine Kinase Inhibitors Should Be Selected as the First-Line Treatment for Chronic Myelogenous Leukemia in Chronic Phase?

Ono

2021

Cancers

View full text Add to dashboard Cite

With the use of tyrosine kinase inhibitors (TKIs), chronic myelogenous leukemia in chronic phase (CML-CP) has been transformed into a non-fatal chronic disease. Hence, "treatment-free remission (TFR)" has become a possible treatment goal of patients with CML-CP. Currently, four types of TKIs (imatinib, nilotinib, dasatinib, and bosutinib) are used as the first-line treatment for newly diagnosed CML-CP. However, the second-generation TKI (2GTKI), the treatment response of which is faster and deeper than that of imatinib, is not always recommended as the first-line treatment for CML-CP. Factors involved in TKI selection in the first-line treatment of CML-CP include not only patients’ medical background, but also patients’ choice regarding the desired treatment goal (survival or TFR?). Therefore, it is important that clinicians select an appropriate TKI to successfully achieve the desired treatment goal for each patient, while minimizing the development of adverse events. This review compares the pros and cons of using imatinib and 2GTKI for TKI selection as the first-line treatment for CML-CP, mainly considering treatment outcomes, medical history (i.e., desire for pregnancy, aging factor, and comorbidity), and cost. The optimal use of 2GTKIs is also discussed.

show abstract

“…Leukapheresis can be used for clin i cal signs of injury due to leukostasis and remains a ther a peu tic "bridg ing" strat egy dur ing CML and preg nancy, when cytoreductive ther apy and defn i tive ther apy with TKIs may pose exces sive fetal risk. 14…”

Section: Risks At Pre Sen Ta Tion With a Diag No Sis Of CMLmentioning

confidence: 99%

Lifelong TKI therapy: how to manage cardiovascular and other risks

Mauro

2021

Hematology

View full text Add to dashboard Cite

Beginning with imatinib and now spanning 6 oral, highly active, and mostly safe agents, the development of specific targeted therapy for patients with chronic myeloid leukemia (CML) has created a new world featuring chronic maintenance chemotherapy for all treated as such, treatment-free remission, and functional cure after prolonged deep remission in a subset. As a result comes a necessary shift in focus from acute to chronic toxicity, increasing attention to patient comorbidities, and critical thinking around specific adverse events such as metabolic, cardiovascular, and cardiopulmonary effects, which vary from agent to agent. This review aims to pull together the state of the art of managing the “C” in CML—a chronic myeloproliferative neoplasm treated at present over many years with oral BCR-ABL-targeted agents in a population whose overall health can be complex and potentially affected by disease and therapy—and determine how we can better manage a highly treatable and increasingly curable cancer.

show abstract

Tyrosine kinase inhibitors and pregnancy in chronic myeloid leukemia: opinion, evidence, and recommendations

Cited by 33 publications

References 44 publications

Management of Chronic Myeloid Leukemia and Pregnancy: A Bibliometric Analysis (2000-2020)

Management of Chronic Myeloid Leukemia and Pregnancy: A Bibliometric Analysis (2000-2020)

Which Tyrosine Kinase Inhibitors Should Be Selected as the First-Line Treatment for Chronic Myelogenous Leukemia in Chronic Phase?

Lifelong TKI therapy: how to manage cardiovascular and other risks

Contact Info

Product

Resources

About