title: Maternal, Fetal, and Neonatal Imatinib Levels With Treatment of Chronic Myeloid Leukemia in Pregnancy.
abstract: Pregnant women with chronic myeloid leukemia (CML) can be treated effectively with the tyrosine-kinase inhibitor imatinib, but data regarding fetal and neonatal exposure and safety are limited.
  
  
  
  We present a patient with newly diagnosed CML in early pregnancy. Leukapheresis and interferon-α were initiated in the second trimester with limited benefit. Imatinib was subsequently started at 28 weeks of gestation with complete hematologic response within 4 weeks. No significant maternal or neonatal adverse effects were noted, but imatinib and its primary active metabolite concentrated in maternal breast milk and neonatal urine.
  
  
  
  Imatinib is effective for CML in pregnancy, but caution is warranted in light of potentially unrecognized fetal and neonatal effects.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Knight Cancer Institute, Division of Hematology and Medical Oncology, Oregon Health & Science University, and Howard Hughes Medical Institute, Portland, Oregon.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Burwick
authors.forename: Kelly
authors.initials: K
authors.lastname: Kuo
authors.forename: Diana
authors.initials: D
authors.lastname: Brewer
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Druker
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005260:Female; D005333:Fetus / Q000378:metabolism*; D005865:Gestational Age; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007231:Infant, Newborn; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis
chemical_list: D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate