title: Pregnancy: part of life in chronic myelogenous leukemia.
abstract: Management of pregnant patients with chronic myelogenous leukemia (CML) is challenging. Some of the factors that need to be considered include stage of pregnancy, disease status, and degree of drug exposure. Managing a patient who has been diagnosed while pregnant requires a different approach as compared with a patient who becomes pregnant while on the treatment with a tyrosine kinase inhibitor (TKI). Younger patients may wish to conceive while on treatment and need a more personalized treatment plan based on the degree and duration of their molecular status. Leukapheresis and interferon are useful options in this situation due to teratogenic potential of TKIs. We present a series of clinical vignettes describing our approach to different scenarios and the management options employed in each case. Despite the era of TKIs and their undoubted efficacy and safety, situations such as these require an individualized and multidisciplinary approach to management.
authors.affiliation: a Princess Margaret Cancer Centre, Division of Medical Oncology and Hematology , University Health Network, University of Toronto , Toronto , ON , Canada.
authors.forename: Arjun Datt
authors.initials: AD
authors.lastname: Law
authors.affiliation: b Princess Margaret Cancer Centre, Division of Medical Oncology and Hematology , University Health Network, University of Toronto , Toronto , ON , Canada.
authors.forename: Dennis
authors.initials: D
authors.lastname: Dong Hwan Kim
authors.affiliation: c Princess Margaret Cancer Centre, Division of Medical Oncology and Hematology , University Health Network, University of Toronto , Toronto , ON , Canada.
authors.forename: Jeffrey Howard
authors.initials: JH
authors.lastname: Lipton
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001942:Breast Feeding; D019468:Disease Management; D005193:Family Planning Services; D005260:Female; D005298:Fertility / Q000187:drug effects; D047109:Fetal Development / Q000187:drug effects; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000188:drug therapy*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000188:drug therapy*; D011256:Pregnancy Outcome; D049168:Pregnancy, Unplanned; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors
keywords: Chronic myelogenous leukemia; interferon; pregnancy