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Title: The effect of tyrosine kinase inhibitor interruption and interferon use on pregnancy outcomes and long-term disease control in chronic myeloid leukemia.
Austin Authors: Lasica, Masa;Willcox, Abbey ;Burbury, Kate;Ross, David M;Branford, Susan;Butler, Jason;Filshie, Robin;Januszewicz, Henry;Joske, David;Mills, Anthony;Simpson, David;Tam, Constantine;Taylor, Kerry;Watson, Anne-Marie;Wolf, Max;Grigg, Andrew P 
Affiliation: Australian Centre for Blood Disease, Monash University, Melbourne, Australia
St Vincent's Hospital, Fitzroy, Australia
Royal Brisbane and Women's Hospital, Brisbane, Australia
Centre for Cancer Biology, an alliance between SA Pathology and University of South Australia, Adelaide, Australia
Bedford Park, Flinders University and Medical Centre, Adelaide Australia
Department of Clinical Haematology, Austin Health, Heidelberg, Victoria, Australia
Peter MacCallum Cancer Centre, East Melbourne, Australia
Icon Cancer Care, Mater Medical Centre, South Brisbane, Australia
Ramsay Specialist Centre, Greenslopes Private Hospital, Greenslopes, Australia
Sir Charles Gairdner Hospital, Nedlands, Australia
North Shore Hospital, Waitemata District Health Board, Auckland, New Zealand
Liverpool Hospital, Liverpool, Australia
Issue Date: Jul-2019 2019-01-11
Publication information: Leukemia & lymphoma 2019; 60(7): 1796-1802
Abstract: The management of CML in pregnancy is challenging with the need to balance disease control against potential teratogenic effects of TKI therapy. In this multi-center case-cohort study of 16 women in chronic phase, CML ceased TKI treatment pre- or post-conception during their first pregnancy. Thirteen patients were on imatinib; 9 ceased their TKI prior to conception and 7 ceased at pregnancy confirmation. Twelve patients had achieved either MMR or better at time of TKI cessation. Eleven women lost MMR during pregnancy and two patients lost CHR. Fourteen women reestablished MMR on TKI recommenced. The depth molecular response prior to conception appeared to correlate well with restoration of disease control on TKI recommencement though duration of MMR did not appear to be as important. While interruption of TKI treatment for pregnancy usually leads to loss of molecular response, loss of hematological response is uncommon and disease control is reestablished with resumption of therapy in the majority of women.
DOI: 10.1080/10428194.2018.1551533
ORCID: 0000-0002-9343-542X
PubMed URL: 30632843
Type: Journal Article
Subjects: Chronic myeloid leukemia
tyrosine kinase inhibitor
Appears in Collections:Journal articles

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