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一名慢性髓性白血病患者在三次不同孕期分别接受三种酪氨酸激酶抑制剂治疗后的三次妊娠结局:病例随访及已发表报告综述

Outcome of 3 pregnancies in a patient with chronic myeloid leukemia who received 3 types of tyrosine kinase inhibitors each in different pregnancy: follow-up of the case with a review of published reports.

作者信息

Alizadeh Hussain, Jaafar Hassan, Kajtár Béla

机构信息

Hussain Alizadeh, Kaposi Mór Teaching Hospital,, Tallián Gyula Street 20-32,, 7400-Kaposvár, Hungary, T: (+36) 82-501341, F: (+36) 82-510076, M: (+36) 30-6436099,

出版信息

Ann Saudi Med. 2015 Nov-Dec;35(6):468-71. doi: 10.5144/0256-4947.2015.468.

Abstract

The management of patients with chronic myeloid leukemia (CML) during pregnancy remains a matter of continuous debate. Tyrosine kinase inhibitors (TKIs) have become the standard of care in managing patients with CML. These drugs have a good safety profile, but animal studies have shown that they are potentially teratogenic. Therefore, these drugs are not recommended for use during pregnancy or if a female patient plans to conceive. Despite the extensive clinical experience with TKIs, the available information about the effects of TKIs on fertility, pregnancy, and outcome of babies who were exposed to TKIs during pregnancy and lactation is limited. We reported on 1 female CML patient who conceived 3 times while being on different types of TKIs in each pregnancy. All 3 pregnancies were uneventful, and only 1 of the babies was diagnosed with a minor cardiac malformation at the age of 30 months, which was corrected surgically.

摘要

慢性髓性白血病(CML)患者孕期的管理仍是一个持续争论的问题。酪氨酸激酶抑制剂(TKIs)已成为治疗CML患者的标准疗法。这些药物具有良好的安全性,但动物研究表明它们可能具有致畸性。因此,不建议在孕期使用这些药物,或者女性患者计划怀孕时使用。尽管TKIs有广泛的临床经验,但关于TKIs对生育能力、妊娠以及孕期和哺乳期接触TKIs的婴儿结局影响的现有信息有限。我们报告了1例女性CML患者,她在每次怀孕时使用不同类型的TKIs期间受孕3次。所有3次妊娠均顺利,只有1名婴儿在30个月大时被诊断出患有轻度心脏畸形,已通过手术矫正。

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