The management of pregnancy in paroxysmal nocturnal haemoglobinuria on long term eculizumab.
In Paroxysmal nocturnal haemoglobinuria (PNH), pregnancy is associated with increased maternal and foetal complications to such an extent that the condition has been considered relatively contra-indicated in PNH. Eculizumab has revolutionized the treatment of PNH. We evaluate its use in pregnancy to date. We report on seven patients exposed to eculizumab at different stages of pregnancy including the first two patients to receive the drug from conception to delivery. There was no evidence of complement blockade from cord blood samples taken at delivery. Eculizumab appears safe to use in this setting and is likely to prevent many of the complications usually observed.
Institute of Oncology, St James's University Hospital, Leeds, UK. richardkelly@nhs.net
Richard
R
Kelly
Louise
L
Arnold
Stephen
S
Richards
Anita
A
Hill
Charlotte
C
Bomken
John
J
Hanley
Andrew
A
Loughney
Jon
J
Beauchamp
Gus
G
Khursigara
Russell P
RP
Rother
Elizabeth
E
Chalmers
Andrew
A
Fyfe
Edward
E
Fitzsimons
Ryotaro
R
Nakamura
Anna
A
Gaya
Antonio M
AM
Risitano
Jörg
J
Schubert
Derek
D
Norfolk
Nigel
N
Simpson
Peter
P
Hillmen
D000328:Adult; D000911:Antibodies, Monoclonal / Q000097:blood / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006457:Hemoglobinuria, Paroxysmal / Q000188:drug therapy*; D006801:Humans; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D055815:Young Adult
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C481642:eculizumab