Conception, Pregnancy Possible During TKI Therapy for Chronic Myeloid Leukemia

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Childbearing during TKI therapy for CML is possible, although women should cease therapy at least until placental maturation.
Childbearing during TKI therapy for CML is possible, although women should cease therapy at least until placental maturation.
The following article features coverage from the American Society of Hematology (ASH) 2018 meeting. Click here to read more of Oncology Nurse Advisor's conference coverage.

Patients with chronic myeloid leukemia (CML) who are treated with tyrosine kinase inhibitors (TKIs) are able to conceive and have a child, even during therapy, according to a study presented at the 2018 American Society of Hematology (ASH) Annual Meeting and Exposition.

Prognoses for patients with CML has improved greatly with the advent of tyrosine kinase inhibitors (TKIs) and precise molecular monitoring, so much so that pregnancy and childbearing are possible for both male and female patients with CML. 

In this retrospective and prospective study, the Gimema CML working party sought to analyze conceptions and pregnancies in male and female patients with CML, focusing on 3 general issues: illness, conception/pregnancy, and postnatal health. Participants in the study were aged 18 years or older; had a confirmed diagnosis of CML; attempted conception or achieved pregnancy; received treatment with a TKI before, during, and/or after pregnancy; and signed an IRB-approved written informed consent form. 

Of 143 enrollees, data were obtained from 135 patients with CML (83 male, 52 female). A total of 166 cases were analyzable; 106 were conceptions involving male patients and 60 were pregnancies in female patients.

Illness issuesincluded treatment for CML prior to conception or during/after pregnancy, transcript kinetics, recovery of a lost response after therapy cessation, and effects of treatment modification (eg, resistance, switching). At the time of conception, 34 patients had received no treatment, 8 had received interferon-a (IFN), and all others were treated with a TKI. All of the female patients had stopped TKI therapy when their pregnancies were discovered (at 3 to 6 weeks). Some patients resumed treatment at 20 weeks or later: 13 patients were treated with IFN, 2 with imatinib, and 1 with nilotinib. 

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