Cole Suzanne, Kantarjian Hagop, Ault Patricia, Cortés Jorge E
Department of Leukemia, The University of Texas, M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Clin Lymphoma Myeloma. 2009 Aug;9(4):324-7. doi: 10.3816/CLM.2009.n.064.
The management of patients with chronic myeloid leukemia (CML) during pregnancy is a matter of continued debate. We present a 21-year-old woman in whom CML was diagnosed during early pregnancy. Because the patient was asymptomatic and desired to carry the pregnancy to term while minimizing fetal exposure to medication, she was observed with no therapy for the duration of her pregnancy. The white blood cell count showed a slow downward trend throughout her pregnancy. She delivered a healthy baby and breast fed for a time before initiating therapy for CML. We reviewed the published case reports of women who had a pregnancy occur in the setting of treatment with imatinib. Given the adverse effects of fetal exposure to imatinib as treatment for the mother with CML, close observation might be an option for selected patients who are diagnosed with CML while pregnant and who have minimal clinical manifestations of CML.
慢性髓性白血病(CML)患者孕期的管理一直存在争议。我们报告一名21岁女性,在妊娠早期被诊断为CML。由于患者无症状且希望足月分娩同时尽量减少胎儿接触药物,在整个孕期她未接受治疗,仅接受观察。在整个孕期,她的白细胞计数呈缓慢下降趋势。她产下一名健康婴儿,并在开始CML治疗前进行了一段时间的母乳喂养。我们回顾了已发表的关于接受伊马替尼治疗期间怀孕的女性的病例报告。鉴于胎儿接触伊马替尼作为CML母亲的治疗药物存在不良反应,对于孕期被诊断为CML且CML临床表现轻微的特定患者,密切观察可能是一种选择。