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孕期使用环磷酰胺:一项安全的处方

[Cyclophosphamide during pregnancy: a safe prescription].

作者信息

Nguyen Tan Lung R, Granier M, Gaudry C, Kourilsky O

机构信息

Département Mère-Enfant, CHG Louise-Michel, Quartier du Canal, Evry.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1995;24(3):314-8.

PMID:7622780
Abstract

Cyclophosphamide is an alkylating agent used to treat haematologic malignant diseases and multisystem diseases with progressive glomerulonephritis. It is rarely prescribed during pregnancy. We report a case of Henoch-Schönlein purpura discovered at the end of the first trimester of pregnancy. Despite steroid therapy, glomerulonephritis worsened and 100 mg/day cyclophosphamide per os was administered from 28th week till delivery. The infant, prematurely born, was normal and did not have any haematological disorder. Congenital malformations are often reported (5 out of 19 newborns exposed in utero to cyclophosphamide), but in all those cases, there was another potentially teratogenic agent: either radiotherapy or another antineoplastic drug. Therefore, if mother's life is in jeopardy, cyclophosphamide therapy should be given and not postponed.

摘要

环磷酰胺是一种烷化剂,用于治疗血液系统恶性疾病和伴有进行性肾小球肾炎的多系统疾病。孕期很少使用该药。我们报告一例在妊娠早期发现的过敏性紫癜病例。尽管进行了类固醇治疗,但肾小球肾炎仍恶化,从孕28周直至分娩口服给予环磷酰胺100mg/天。婴儿早产,身体正常,未出现任何血液系统疾病。先天性畸形常有报道(19例子宫内暴露于环磷酰胺的新生儿中有5例),但在所有这些病例中,都存在另一种潜在致畸剂:放疗或另一种抗肿瘤药物。因此,如果母亲生命垂危,应给予环磷酰胺治疗而不应推迟。

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