The effect of tyrosine kinase inhibitor interruption and interferon use on pregnancy outcomes and long-term disease control in chronic myeloid leukemia

Masa Lasica, Abbey Willcox, Kate Burbury, David M. Ross, Susan Branford, Jason Butler, Robin Filshie, Henry Januszewicz, David Joske, Anthony Mills, David Simpson, Constantine Tam, Kerry Taylor, Anne Marie Watson, Max Wolf, Andrew Grigg

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The management of CML in pregnancy is challenging with the need to balance disease control against potential teratogenic effects of TKI therapy. In this multi-center case-cohort study of 16 women in chronic phase, CML ceased TKI treatment pre- or post-conception during their first pregnancy. Thirteen patients were on imatinib; 9 ceased their TKI prior to conception and 7 ceased at pregnancy confirmation. Twelve patients had achieved either MMR or better at time of TKI cessation. Eleven women lost MMR during pregnancy and two patients lost CHR. Fourteen women reestablished MMR on TKI recommenced. The depth molecular response prior to conception appeared to correlate well with restoration of disease control on TKI recommencement though duration of MMR did not appear to be as important. While interruption of TKI treatment for pregnancy usually leads to loss of molecular response, loss of hematological response is uncommon and disease control is reestablished with resumption of therapy in the majority of women.

Original languageEnglish
Pages (from-to)1796-1802
Number of pages7
JournalLeukemia and Lymphoma
Volume60
Issue number7
DOIs
Publication statusPublished - 7 Jun 2019
Externally publishedYes

Keywords

  • Chronic myeloid leukemia
  • dasatinib
  • imatinib
  • nilotinib
  • pregnancy
  • tyrosine kinase inhibitor

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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