Bhandari Amit, Rolen Katrina, Shah Binay Kumar
Cancer Center and Blood Institute, St. Joseph Regional Medical Center, Lewiston, ID, U.S.A.
Anticancer Res. 2015 Jan;35(1):1-11.
Discovery of tyrosine kinase inhibitors has led to improvement in survival of chronic myelogenous leukemia (CML) patients. Many young CML patients encounter pregnancy during their lifetime. Tyrosine kinase inhibitors inhibit several proteins that are known to have important functions in gonadal development, implantation and fetal development, thus increasing the risk of embryo toxicities. Studies have shown imatinib to be embryotoxic in animals with varying effects in fertility. Since pregnancy is rare in CML, there are no randomized controlled trials to address the optimal management of this condition. However, there are several case reports and case series on CML in pregnancy. At the present time, there is no consensus on how to manage different pregnancy situations in CML. In this article, we review current literature on CML in pregnancy, discuss the effects of several tyrosine kinase inhibitors on fertility and pregnancy and suggest an evidence-based treatment of CML in pregnancy.
酪氨酸激酶抑制剂的发现提高了慢性粒细胞白血病（CML）患者的生存率。许多年轻的CML患者在其一生中会经历怀孕。酪氨酸激酶抑制剂会抑制几种已知在性腺发育、着床和胎儿发育中具有重要功能的蛋白质，从而增加胚胎毒性的风险。研究表明，伊马替尼在动物中具有胚胎毒性，对生育能力有不同影响。由于CML患者怀孕的情况很少见，因此没有随机对照试验来探讨这种情况的最佳管理方法。然而，有几篇关于孕期CML的病例报告和病例系列。目前，对于如何处理CML患者不同的怀孕情况尚无共识。在本文中，我们回顾了关于孕期CML的当前文献，讨论了几种酪氨酸激酶抑制剂对生育和怀孕的影响，并提出了基于证据的孕期CML治疗方法。
