Imatinib use during pregnancy and breast feeding: A case report and review of the literature
| Přispěvatelé: | Uludağ Üniversitesi/Tıp Fakültesi/ İç Hastalıkları Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Genetik Anabilim Dalı., Ali, Rıdvan, Özkalemkaş, Fahir, Kimya, Yalçın, Köksal, Nligün, Özkocaman, Vildan, Gülten, Tuna, Yorulmaz, Hakan, Tunalı, Ahmet Semih, AAH-1854-2021, AAG-8495-2021, AAG-8393-2021 |
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| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Male
Fetus risk Blood sampling Leukocytosis Child growth Review Treatment response Drug milk level Piperazines Infant newborn Targeted therapy Issues BCR ABL protein Umbilical cord blood Drug blood level Teratogenicity Pregnancy hemic and lymphatic diseases Antineoplastic agents Hydroxyurea Obstetrics & gynecology Disease course Treatment outcome Cml Child development Vaginal delivery Cancer Drug tolerability Prenatal drug exposure 2 [2 methyl 5 [4 (1 piperazinylmethyl)benzamido]anilino] 4 (3 pyridyl)pyrimidine Patient Chronic myeloid leukemia Anemia Puerperium Infant peripheral blood Prognosis Management Amnion fluid Female Safety Human Adult Breast milk Fetus echography Maternal blood Breast feeding Leukemia myeloid chronic-phase Milk human Cytogenetics Case report Mesylate Humans Leukapheresis Apgar score neoplasms Chronic myeloid-leukemia Spontaneous abortion Fetus growth Gestational age Philadelphia chromosome positive cell Leukemia remission Labor induction Chronic Myeloid Leukemia Imatinib Thrombocythemia Pyrimidines Pregnancy complications neoplastic Drug determination Drug tolerance High performance liquid chromatography |
| Popis: | The development of imatinib as a therapeutic agent targeting BCR-ABL has increased the treatment options for chronic myeloid leukemia (CML) by significantly impacting outcomes, and imatinib is recommended by treatment guidelines as the first-line therapy. However, treatment of maternal CML with imatinib during gestation is not recommended because of the potential risk to the fetus. We describe the clinical presentation, course and outcome of one pregnant patient with CML who was treated with imatinib. We review all pregnancies associated with imatinib documented in the literature. A 27-year-old pregnant patient was diagnosed to have Philadelphia chromosome positive chronic phase CML in August 2007. Imatinib was administered (400 mg/day) between the 21st and 39th weeks of gestation. The patient tolerated the drug well and achieved complete hematological and cytogenetic remission. There were no imatinib-related maternal complications during the pregnancy. Fetal growth remained normal as well as amniotic fluid volume estimation. Labor was induced at the 39th gestational week, resulting in the uneventful vaginal delivery of a healthy male infant without any congenital anomaly. Umbilical cord blood and infant peripheral blood were collected at delivery. No postnatal complications occurred; however, imatinib was present in the umbilical cord blood (338 ng/mL) and in the infant's peripheral blood (478 ng/mL). Breast milk was collected on different postpartum days, and concentrations of imatinib were detected. At 10 months of age, the baby had normal growth and development. In light of reported cases and our experience, treatment of CML during the second and third trimesters of gestation and breast feeding seems to be safe, but the data are still limited and the effects of chronic exposure of infants to imatinib are not known. We think that each case should be examined and considered independently, and decisions should be individualized. Novartis Pharmaceutical Corporation |
| Databáze: | OpenAIRE |
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