Báez-de la Fuente Enrique, Arellano-Severiano Baltazar
Servicio de Hematología, Hospital de Especialidades 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México.
Rev Med Inst Mex Seguro Soc. 2014 May-Jun;52(3):342-5.
Imatinib has changed the natural history of chronic myeloid leukemia. There are women with chronic myeloid leukemia in reproductive age with pregnancy desires. The aim of this case was to report the course and outcome of pregnancy in a patient with chronic myeloid leukemia diagnosis treated with imatinib.
A 32 year old female with diagnosis of chronic myeloid leukemia with follow-up of 11 years. She received standard treatment, but she reported poor adherence; therefore, she received imatinib therapy two years after the diagnosis. The patient stopped the treatment herself because she was looking to be pregnant. She presented amenorrhea, which lasted for six weeks; pregnancy was confirmed. During a period of 10 months, she remained untreated and there were no symptoms of leukemia progression. The pregnancy was terminated by cesarean section at 35.5 weeks of gestation. The product was born healthy. In the post-cesarean visit, the lab showed a cell blood count which reported: hemoglobin 8.7 g/dL, hematocrit 25 %, white blood cell 22,000/mL, platelets 170,000/mL. Since October the patient resumed imatinib 600 mg/day.
The prolonged period of treatment with imatinib had no effect on the pregnancy and the product. The molecular monitoring showed the need to reinstall the treatment once the pregnancy finished. The efficacy and safety of treatment allows patients to fulfill life projects that seemed distant in other time.
伊马替尼改变了慢性髓性白血病的自然病程。有一些处于育龄期且有妊娠意愿的慢性髓性白血病女性患者。本病例的目的是报告一名接受伊马替尼治疗的慢性髓性白血病患者的妊娠过程及结局。
一名32岁女性，诊断为慢性髓性白血病，病程11年。她接受了标准治疗，但自述依从性差；因此，确诊两年后开始接受伊马替尼治疗。患者因希望怀孕自行停药。她出现闭经，持续六周，妊娠得到确诊。在10个月的时间里，她未接受治疗，也没有白血病进展的症状。妊娠在孕35.5周时通过剖宫产终止。婴儿健康出生。剖宫产术后复查时，实验室检查显示血细胞计数为：血红蛋白8.7g/dL，血细胞比容25%，白细胞22,000/mL，血小板170,000/mL。自10月起，患者恢复每日服用600mg伊马替尼。
伊马替尼的长期治疗对妊娠及胎儿没有影响。分子监测显示妊娠结束后需要重新开始治疗。治疗的有效性和安全性使患者能够实现曾经看似遥不可及的人生计划。
