Contributions
Type: Publication Only
Background
TKIs have dramatically modified the outcome of CML patients giving opportunity to 10% of patients that are in age to procreate to have a parental project.TKIs stopping leads to the relapse. We count the event of pregnancy and its evolution among patients with CML at Chronic Phase treated with TKIs in the two sexes at Blida in Algeria.
Aims
To evaluate in the two sexes fertility of patients treated by tyrosine kinase inhibitors.
Methods
Of 231 CML patients treated by TKIs, 29 pregnancies were noted among 19 women ; we analyze the time of exposure to the TKIs before and at the time of the pregnancy and the hematologic, cytogenetic and molecular status before and after the pregnancy.
Results
Pregnancy of the spouse:
- Husbands treated by Imatinib (IM): 10 cases, median age = 34 years; IM (400mg/d) ; median time of exposure (MTE) = 23 months ; No interruption of IM before the conception ; 3 early abortions; 12 pregnancies carried out in the term; 12 alive new-born without malformation.
- Husbands treated by Dasatinib: 2 Cases (100mg/d; MTE before the conception (BTC) = 12 months, not treatment stopping before the design; 02 pregnancies carried out in the term; 2 alive new-born, no malformations.
- Husbands treated by Nilotinib: 1 case (800 mg/d), MTE BTC = 12 months, no stop of TKI before the conception ; 1 pregnancy carried out in the term; 1 new-born living any malformation
Pregnancies not planned in 0 3 women treated by Imatinib: median age = 31 years; median time of impregnation BTC : 19 months (4, 24, 39); Cytogenetic profile: CCyR = 2 patients, MMR: 1 pt; no treatment stopping before the conception ; exposure time to the IM of 6, 8 and 12 weeks; Evolution of the pregnancy without incidents; childbirth at 35 weeks = 2 pts, 1 Caesarian ( after acceleration phase); 03 alive new-born of weight (2400-3500 gr) without malformations; Evolution of the CML: loss of the hematologic remission at 20 weeks = 3 patients of which one acceleration, relayed by interferon ; No breast feeding ; resumption of IM = 3 pts, one blast phase (AML5) treated by Nilotinib, which died after 12 months; 2 pts with HR and CCyR after 12 months of recovery
Pregnancies planned in 5 women treated by Imatinib: 4 (G0P0), 01 (G2P1); median age = 29 years; sokal high = 2 pts: Intermediary = 3 pts; MTE BTC = 48 months (30-60) with IM 400 mg/d; cytogenetic profile = 5 CCyR, 2 MMR 4 .5 and 2 MMR 4; stop of IM BTC = 5 pts, from 01 to 05 months; 2 early abortions 1 month from stopping ; 5 pregnancies 3 to 5 months after stopping IM; Evolution of the pregnancy: without incidents, of which one treated by interferon; Childbirth: in the term = 4 pts; 5 alive new-born (twin) without malformations; 1 in progress; breast feeding: 3 pts (1 month); Evolution of CML = CHR maintained at 37 weeks = 4 patients, a loss of the CHR; resumption of IM = 4 Pts, MMR in one pt after 12 months of recovery OS = 75 months; 3 still of evaluation, OS = 61 months (46 - 83)
Pregnancy in woman treated by Dasatinib: 30 years, sokal: Intermediary; G0P0; MTE BTC: 18 months, Cytogenetics: CCyR ; no treatment stopping before the conception ; pregnancy not planned; exposure time: 4 weeks; lost of follow up until the childbirth, new-born alive without malformations, Evolution of the CML: loss of HR; Resumption of Dasatinib, HR after 2 months, CCyR after 3 months, OS = 65 months
Summary
Infertility is not an side effect of the TKIs; the major molecular response made it possible to carry out a pregnancy without relay, a non-response requires a relay and exposes to the risks
Keyword(s): Chronic myeloid leukemia, Imatinib, Pregnancy
Session topic: Publication Only
Type: Publication Only
Background
TKIs have dramatically modified the outcome of CML patients giving opportunity to 10% of patients that are in age to procreate to have a parental project.TKIs stopping leads to the relapse. We count the event of pregnancy and its evolution among patients with CML at Chronic Phase treated with TKIs in the two sexes at Blida in Algeria.
Aims
To evaluate in the two sexes fertility of patients treated by tyrosine kinase inhibitors.
Methods
Of 231 CML patients treated by TKIs, 29 pregnancies were noted among 19 women ; we analyze the time of exposure to the TKIs before and at the time of the pregnancy and the hematologic, cytogenetic and molecular status before and after the pregnancy.
Results
Pregnancy of the spouse:
- Husbands treated by Imatinib (IM): 10 cases, median age = 34 years; IM (400mg/d) ; median time of exposure (MTE) = 23 months ; No interruption of IM before the conception ; 3 early abortions; 12 pregnancies carried out in the term; 12 alive new-born without malformation.
- Husbands treated by Dasatinib: 2 Cases (100mg/d; MTE before the conception (BTC) = 12 months, not treatment stopping before the design; 02 pregnancies carried out in the term; 2 alive new-born, no malformations.
- Husbands treated by Nilotinib: 1 case (800 mg/d), MTE BTC = 12 months, no stop of TKI before the conception ; 1 pregnancy carried out in the term; 1 new-born living any malformation
Pregnancies not planned in 0 3 women treated by Imatinib: median age = 31 years; median time of impregnation BTC : 19 months (4, 24, 39); Cytogenetic profile: CCyR = 2 patients, MMR: 1 pt; no treatment stopping before the conception ; exposure time to the IM of 6, 8 and 12 weeks; Evolution of the pregnancy without incidents; childbirth at 35 weeks = 2 pts, 1 Caesarian ( after acceleration phase); 03 alive new-born of weight (2400-3500 gr) without malformations; Evolution of the CML: loss of the hematologic remission at 20 weeks = 3 patients of which one acceleration, relayed by interferon ; No breast feeding ; resumption of IM = 3 pts, one blast phase (AML5) treated by Nilotinib, which died after 12 months; 2 pts with HR and CCyR after 12 months of recovery
Pregnancies planned in 5 women treated by Imatinib: 4 (G0P0), 01 (G2P1); median age = 29 years; sokal high = 2 pts: Intermediary = 3 pts; MTE BTC = 48 months (30-60) with IM 400 mg/d; cytogenetic profile = 5 CCyR, 2 MMR 4 .5 and 2 MMR 4; stop of IM BTC = 5 pts, from 01 to 05 months; 2 early abortions 1 month from stopping ; 5 pregnancies 3 to 5 months after stopping IM; Evolution of the pregnancy: without incidents, of which one treated by interferon; Childbirth: in the term = 4 pts; 5 alive new-born (twin) without malformations; 1 in progress; breast feeding: 3 pts (1 month); Evolution of CML = CHR maintained at 37 weeks = 4 patients, a loss of the CHR; resumption of IM = 4 Pts, MMR in one pt after 12 months of recovery OS = 75 months; 3 still of evaluation, OS = 61 months (46 - 83)
Pregnancy in woman treated by Dasatinib: 30 years, sokal: Intermediary; G0P0; MTE BTC: 18 months, Cytogenetics: CCyR ; no treatment stopping before the conception ; pregnancy not planned; exposure time: 4 weeks; lost of follow up until the childbirth, new-born alive without malformations, Evolution of the CML: loss of HR; Resumption of Dasatinib, HR after 2 months, CCyR after 3 months, OS = 65 months
Summary
Infertility is not an side effect of the TKIs; the major molecular response made it possible to carry out a pregnancy without relay, a non-response requires a relay and exposes to the risks
Keyword(s): Chronic myeloid leukemia, Imatinib, Pregnancy
Session topic: Publication Only