title: Management of pregnant chronic myeloid leukemia patients.
abstract: BACKGROUND
  Since the introduction of tyrosine kinase inhibitors (TKIs) therapy, chronic myeloid leukemia (CML), has moved from a fatal illness to a manageable disease with a possible normal lifespan. For this reason is more and more frequent that younger patients address the possibility to conceive, if men, or get pregnant, if women. Knowledge of safety and risks concerning both patient and progeny, as well as important cultural, ethical and psychosocial issues must be taken into consideration.
  
  
  METHODS
  Data published and informations acquired in terms of fertility, conception, pregnancy, pregnancy outcome and illness control for all the approved TKIs will be reviewed, as well as suggest how to manage a planned and/or unplanned pregnancy/conception. Literature search methodology included examination of PubMed index, meeting presentations, and updated Investigator's brochures and data files of TKIs companies. Expert commentary: Male patients trying to conceive apparently have no limitation in the use of TKIs, while effective contraception should be encouraged in all female patients due to the risk of fetal complications after drug exposure. In a female patient pregnancy should be planned and TKI therapy discontinued, while individual risks need to be considered when an unplanned pregnancy occurs.
authors.affiliation: a Hematology, S. Eugenio Hospital , Tor Vergata University , Rome , Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Abruzzese
authors.affiliation: a Hematology, S. Eugenio Hospital , Tor Vergata University , Rome , Italy.
authors.forename: Malgorzata Monika
authors.initials: MM
authors.lastname: Trawinska
authors.affiliation: a Hematology, S. Eugenio Hospital , Tor Vergata University , Rome , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: de Fabritiis
authors.affiliation: b Department of Hematology & Oncology 'L. and A. Seràgnoli' , S.Orsola-Malpighi University Hospital , Bologna , Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Baccarani
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019468:Disease Management; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000628:therapy*; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D047428:Protein Kinase Inhibitors
keywords: Chronic myeloid leukemia; TKIs; bosutinib; conception; dasatinib; imatinib; nilotinib; ponatinib; pregnancy