Sheng Weiwei, Sun Naitong
Department of Hematology, The Third People's Hospital of Yancheng, 75 Juchanglu, Tinghu District, Yancheng, 224001 Jiangsu People's Republic of China.
Springerplus. 2016 Dec 1;5(1):2055. doi: 10.1186/s40064-016-3693-0. eCollection 2016.
Complications associated with chronic myeloid leukemia (CML) during pregnancy are rare, and management is challenging because very limited data are available on this patient group.
We herein report a successful pregnancy and delivery in a patient diagnosed with CML. The patient was treated with imatinib (400 mg/day) as a first-line therapy. However, she became pregnant while she was in complete hematological remission and had a complete cytogenetic response. Because she elected to continue the pregnancy to term, imatinib treatment was stopped after 5 months of gestation and the patient was then treated with interferon-alpha for the remainder of her pregnancy. However, the CML did not relapse. She successfully gave birth to a male infant at 39 weeks by cesarean section with no adverse sequelae or malformations.
The treatment of pregnant women with CML is difficult because of few available therapeutic options and limited data regarding the potential harm to the fetus. Conception should be planned and TKI therapy discontinued in female patients during pregnancy, and individual risks need to be considered when an unplanned pregnancy occurs.
Our experience will be useful for counseling patients inadvertently exposed to tyrosine kinase inhibitors such as imatinib during pregnancy.
慢性髓性白血病（CML）在妊娠期间的并发症很少见，并且由于关于该患者群体的数据非常有限，管理具有挑战性。
我们在此报告一例被诊断为CML的患者成功妊娠并分娩。该患者接受伊马替尼（400毫克/天）作为一线治疗。然而，她在完全血液学缓解且有完全细胞遗传学反应时怀孕。由于她选择继续妊娠至足月，妊娠5个月后停用伊马替尼治疗，该患者在妊娠剩余时间接受α干扰素治疗。然而，CML并未复发。她在39周时通过剖宫产成功产下一名男婴，没有不良后遗症或畸形。
由于可用的治疗选择很少以及关于对胎儿潜在危害的数据有限，CML孕妇的治疗很困难。应计划受孕，妊娠期间女性患者应停用TKI治疗，意外怀孕时需要考虑个体风险。
我们的经验将有助于为在妊娠期间无意中接触酪氨酸激酶抑制剂如伊马替尼的患者提供咨询。
