| Abstract: |
Although chronic myeloid leukemia (CML) is typically a disease that strikes women after their childbearing years, a significant minority of patients in whom CML is diagnosed are still fertile and wish to have children. This chapter addresses CML management in pregnant patients. It is wise for a patient to defer pregnancy until a stable, high-quality remission has been achieved; the tyrosine kinase inhibitors (TKIs) approved for use in CML are all assigned pregnancy category D status, thus strongly advising against any use in pregnancy. Pregnancies can be managed by a higher-risk obstetrician given the risk of disease recurrence. Genetic counseling and full prenatal testing for chromosome anomalies and birth defects are also recommended. Last, any woman with CML considering pregnancy must carefully consider the required treatment interruption regarding the risk of disease return, relapse, and even progression because retreatment during pregnancy may be delayed. The good news is that in the current climate of pursuit of treatment-free remission, pregnancy of patients with CML should be considered quite feasible and could have good odds of being uneventful. © 2014 John Wiley and Sons, Inc. |
