Comment: Pregnancy outcomes in patients with chronic myeloid leukaemia

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Published: 15 Jun 2019
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Prof Anton Hagenbeek - University of Amsterdam, Amsterdam, The Netherlands

Prof Anton Hagenbeek comments on Dr Ekaterina Chelysheva's session on pregnancy outcomes in patients with chronic myeloid leukaemia (CML) at the 2019 European Hematology Association (EHA) Annual Meeting.

Dr Chelysheva's study did an international survey of pregnant CML patients, finding that the most frequent outcome was labor with a healthy baby.

Prof Hagenbeek remarks that these findings have been made possible by advancements in tyrosine kinase inhibitor treatments, which not only help women to live longer but also do not affect their fertility like past treatments.

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This was an impressive study in female patients with chronic myelocytic leukaemia, an international survey of pregnancies in that women group, and it appeared that in a majority of pregnant women this finished in a labour with healthy babies and only a few congenital abnormalities, 1.7%, which is in the ballpark of what we see in the general population. I think the importance of the study is, in particular, that in comparison with twenty years ago, when tyrosine kinase inhibitors were not available, we transplanted patients, allogeneic transplant within the first year after diagnosis, losing their fertility if you talk about females, and having a chance of dying from the transplant procedure – transplant-related mortality.

Now, since the introduction of imatinib and the second and third generation of tyrosine kinase inhibitors, there’s longevity. These patients live forever, I might say, 95% at ten years without signs of disease, it’s a deep molecular remission. So things like pregnancy, or in other words a normal life, are most important and are in the picture now. That’s why this analysis is important and it also supports women with CML to become pregnant and not stay away from it.

Its particular implication for practice in women, I would say, if they are in the age of fertility, they are looking forward to getting kids, they could do it, and the good guidance of their haematologist of course.

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