Chronic myeloid leukemia diagnosed in pregnancy: management and outcome of 87 patients reported to the European LeukemiaNet international registry.

Autor: Chelysheva E; National Medical Research Center for Hematology, Moscow, Russian Federation. denve@bk.ru., Apperley J; Centre for Haematology, Imperial College London, London, UK., Turkina A; National Medical Research Center for Hematology, Moscow, Russian Federation., Yassin MA; Department of Medical Oncology/ Hematology Section, National Centre For Cancer Care & Research, Doha, Qatar., Rea D; Service d'hématologie Adulte and FiLMC Hôpital Saint-Louis, Paris, France., Nicolini FE; Hematology department and INSERM 1052 CRCL, Centre Léon Bérard, Lyon, France., Barraco D; Division of Hematology, University Hospital 'Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi', Varese, Italy., Kazakbaeva K; Republician Specilized Scientific and Practical Medical Centre of Hematology, Tashkent, Uzbekistan., Saliev S; Republician Specilized Scientific and Practical Medical Centre of Hematology, Tashkent, Uzbekistan., Abulafia AS; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel., Al-Kindi S; Department of Haematology, Sultan Qaboos University, Muscat, Oman., Byrne J; Centre for Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, England, UK., Robertson HF; Centre for Haematology, Imperial College London, London, UK., Cerrano M; Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy., Shmakov R; FSBI «National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov» Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation., Polushkina E; FSBI «National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov» Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation., de Fabritiis P; Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy., Trawinska MM; Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy., Abruzzese E; Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy.
Jazyk: angličtina
Zdroj: Leukemia [Leukemia] 2024 Apr; Vol. 38 (4), pp. 788-795. Date of Electronic Publication: 2024 Feb 23.
DOI: 10.1038/s41375-024-02183-0
Abstrakt: The management of chronic myeloid leukemia (CML) diagnosed during pregnancy is a rare and challenging situation. We report the treatment and outcome of 87 cases diagnosed in chronic phase from 2001-2022 derived from the largest international observational registry, supported by the European LeukemiaNet (ELN), of 400 pregnancies in 299 CML women. Normal childbirth occurred in 76% without an increased rate of birth abnormalities or life-threatening events, including in patients untreated or treated with interferon-α and/or imatinib in 2nd-3rd trimester. The low birth weight rate of 12% was comparable to that seen in the normal population. Elective and spontaneous abortions occurred in 21% and 3%, respectively. The complete hematologic response rate before labor was 95% with imatinib and 47% with interferon only. No disease progression during pregnancy was observed, 28% of the patients switched their therapy at varying times after delivery. Treatment options balance the efficacy and safety for mother and infant: interferon-α can commence in the 1st trimester and continued throughout in cases of good disease control and tolerability. Because of limited placental crossing, selected tyrosine kinase inhibitors (imatinib and nilotinib) seem to be safe and effective options in 2nd and 3rd trimester while hydroxycarbamide offers few benefits.
(© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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