Kondo Takeshi
Blood Disorders Center, Aiiku Hospital.
Rinsho Ketsueki. 2022;63(9):1092-1098. doi: 10.11406/rinketsu.63.1092.
The introduction of tyrosine kinase inhibitors (TKIs) as treatment for patients with chronic myeloid leukemia (CML) has dramatically improved the outcomes. The life expectancy of patients with CML is now comparable to that of the general population. Although the median age of onset of CML is around 60 years, it can also occur in children, adolescents, and young adults. The excellent disease control gives young patients a hope of childbearing. However, TKIs may have teratogenic potentials in the issue of fertility and pregnancy. One possible scenario is to discontinue TKI treatment for conception and pregnancy because treatment-free remission (TFR) is a realistic option for patients with CML in sustained deep molecular remission. Conversely, pregnancy occurs in patients who are ineligible for TFR or who have active CML. Therefore, several treatment strategies should be prepared from the viewpoint of the situation of pregnancy in patients with CML.
酪氨酸激酶抑制剂（TKIs）作为慢性粒细胞白血病（CML）患者的治疗药物，显著改善了治疗效果。目前，CML患者的预期寿命与普通人群相当。尽管CML的发病中位年龄约为60岁，但也可发生于儿童、青少年和年轻成年人。良好的疾病控制让年轻患者有了生育的希望。然而，在生育和妊娠问题上，TKIs可能具有致畸潜力。一种可能的情况是，由于对于处于持续深度分子缓解的CML患者来说，停药缓解（TFR）是一个现实的选择，因此为了受孕和妊娠而停用TKI治疗。相反，妊娠也会发生在不符合TFR条件或患有活动性CML的患者身上。因此，应从CML患者的妊娠情况角度制定几种治疗策略。
