Outcome of 122 pregnancies in essential thrombocythemia patients: A report from the Italian registry.
Pregnancy is a high-risk event in women with essential thrombocythemia (ET). This observational study evaluated pregnancy outcome in ET patients focusing on the potential impact of aspirin (ASA) or interferon alpha (IFN) treatment during pregnancy. We retrospectively analyzed 122 pregnancies in 92 women consecutively observed in the last 10 years in 17 centers of the Italian thrombocythemia registry (RIT). The live birth rate was 75.4% (92/122 pregnancies). The risk of spontaneous abortion was 2.5-fold higher than in the control population (P < 0.01). ASA did not affect the live birth rate (71/93, 76.3% vs. 21/29, 72.4%, P = 0.67). However, IFN treatment during pregnancy was associated with a better outcome than was management without IFN (live births 19/20, 95% vs. 73/102, 71.6%, P = 0.025), and this finding was supported by multivariate analysis (OR: 0.10; 95% CI: 0.013-0.846, P = 0.034). The JAK2 V617F mutation was associated with a poorer outcome (fetal losses JAK2 V617F positive 9/25, 36% vs. wild type 2/24, 8.3%, P = 0.037), and this association was still significant after multivariate analysis (OR: 6.19; 95% CI: 1.17-32.61; P = 0.038). No outcome concordance between first and second pregnancies was found (P = 0.30). Maternal complications occurred in 8% of cases. In this retrospective study, in consecutively observed pregnant ET patients, IFN treatment was associated with a higher live birth rate, while ASA treatment was not. In addition, the JAK2 V617F mutation was confirmed to be an adverse prognostic factor.
Melillo
Lorella
L
Hematology Unit, San Giovanni Rotondo, Italy.
Tieghi
Alessia
A
Candoni
Anna
A
Radaelli
Franca
F
Ciancia
Rosanna
R
Specchia
Giorgina
G
Martino
Bruno
B
Scalzulli
Potito Rosario
PR
Latagliata
Roberto
R
Palmieri
Fausto
F
Usala
Emilio
E
Valente
Daniela
D
Valvano
Maria Rosa
MR
Cedrone
Michele
M
Comitini
Giuseppina
G
Martinelli
Vincenzo
V
Cascavilla
Nicola
N
Gugliotta
Luigi
L
D000293:Adolescent; D000328:Adult; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007370:Interferon Type I / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D053614:Janus Kinase 2 / Q000235:genetics; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D010298:Parity; D010976:Platelet Count; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics / Q000517:prevention & control; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011994:Recombinant Proteins; D012042:Registries; D012189:Retrospective Studies; D013920:Thrombocythemia, Essential / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D055815:Young Adult
D007370:Interferon Type I; D011994:Recombinant Proteins; C507924:JAK2 protein, human; D053614:Janus Kinase 2; D001241:Aspirin