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.
Kelly
Richard
R
Institute of Oncology, St James's University Hospital, Leeds, UK. richardkelly@nhs.net
Arnold
Louise
L
Richards
Stephen
S
Hill
Anita
A
Bomken
Charlotte
C
Hanley
John
J
Loughney
Andrew
A
Beauchamp
Jon
J
Khursigara
Gus
G
Rother
Russell P
RP
Chalmers
Elizabeth
E
Fyfe
Andrew
A
Fitzsimons
Edward
E
Nakamura
Ryotaro
R
Gaya
Anna
A
Risitano
Antonio M
AM
Schubert
Jörg
J
Norfolk
Derek
D
Simpson
Nigel
N
Hillmen
Peter
P
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