Abstract
To report a case of successful pregnancy in a patient with chronic myelogenous leukemia treated with imatinib mesylate for the first 4 months of pregnancy. Imatinib mesylate is potentially teratogenic and its use during pregnancy in humans can lead to abortion or development of fetal abnormalities in nearly 40% of fully reported cases. We report a case of a 28-year-old woman who delivered a healthy child of normal weight after having been treated with imatinib for Ph1-positive CML during the first four months of her pregnancy. She refused advocated interruption and for the rest of the pregnancy was treated with interferon. The treatment was associated with a rapid 2-log increase in the leukemia clone measured by the real-time polymerase chain reaction. Reintroduction of imatinib after delivery resulted in achievement of the complete cytogenetic response again. We discuss possible strategies for successful management of pregnancy in CML patients treated with imatinib.
Highlights
Chronic myelogenous leukemia (CML) is a myeloproliferative disease characterized by the fusion gene BCR-ABL
Since its introduction in 1998, imatinib mesylate (IM), a competitive inhibitor of Bcr-Abl tyrosine kinase, has been used in CML and it became the drug of choice for first-line treatment of CML
Occasional cases of conception or successful pregnancy during IM treatment have been reported in the literature, mostly as case reports[2,3,4,5,6,7,8,9,10]
Summary
Imatinib mesylate is potentially teratogenic and its use during pregnancy in humans can lead to abortion or development of fetal abnormalities in nearly 40% of fully reported cases. We report a case of a 28-year-old woman who delivered a healthy child of normal weight after having been treated with imatinib for Ph1-positive CML during the first four months of her pregnancy. She refused advocated interruption and for the rest of the pregnancy was treated with interferon. Reintroduction of imatinib after delivery resulted in achievement of the complete cytogenetic response again
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