Austin Health

Title
The effect of tyrosine kinase inhibitor interruption and interferon use on pregnancy outcomes and long-term disease control in chronic myeloid leukemia.
Publication Date
2019-07
Author(s)
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
Subject
Chronic myeloid leukemia
dasatinib
imatinib
nilotinib
pregnancy
tyrosine kinase inhibitor
Type of document
Journal Article
OrcId
0000-0002-9343-542X
0000-0001-7171-2935
DOI
10.1080/10428194.2018.1551533
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.
Link
Citation
Leukemia & lymphoma 2019; 60(7): 1796-1802
Jornal Title
Leukemia & lymphoma

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