Burwick Richard M, Kuo Kelly, Brewer Diana, Druker Brian J
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Knight Cancer Institute, Division of Hematology and Medical Oncology, Oregon Health & Science University, and Howard Hughes Medical Institute, Portland, Oregon.
Obstet Gynecol. 2017 May;129(5):831-834. doi: 10.1097/AOG.0000000000001972.
Pregnant women with chronic myeloid leukemia (CML) can be treated effectively with the tyrosine-kinase inhibitor imatinib, but data regarding fetal and neonatal exposure and safety are limited.
We present a patient with newly diagnosed CML in early pregnancy. Leukapheresis and interferon-α were initiated in the second trimester with limited benefit. Imatinib was subsequently started at 28 weeks of gestation with complete hematologic response within 4 weeks. No significant maternal or neonatal adverse effects were noted, but imatinib and its primary active metabolite concentrated in maternal breast milk and neonatal urine.
Imatinib is effective for CML in pregnancy, but caution is warranted in light of potentially unrecognized fetal and neonatal effects.
慢性髓性白血病（CML）孕妇可使用酪氨酸激酶抑制剂伊马替尼进行有效治疗，但关于胎儿和新生儿暴露及安全性的数据有限。
我们报告一名在妊娠早期新诊断为CML的患者。在孕中期开始进行白细胞单采术和α干扰素治疗，效果有限。随后在妊娠28周开始使用伊马替尼，4周内获得完全血液学缓解。未观察到明显的母体或新生儿不良反应，但伊马替尼及其主要活性代谢产物在母体母乳和新生儿尿液中浓缩。
伊马替尼对妊娠期CML有效，但鉴于可能存在未被认识到的胎儿和新生儿影响，需谨慎使用。
