Investigating the results of planned pregnancy in female patients who are diagnosed with chronic myeloid leukemia (CML) and are receiving tyrosine kinase inhibitors (TKIs) was the main objective of a study. The researchers retrospectively analyzed the information about the female patients who went through with the planned pregnancy. They selected 17 patients altogether who had experienced a major molecular response (MMR) during nilotinib (n=4) or imatinib (n=13) therapy at the minimum before the planned pregnancy. During the time they interrupted the TKI therapy, 2 of the 17 patients were in molecular response 4 (MR4) and 9 were in molecular response 4.5 (MR4.5). Also, 6 of them were in MMR. Four out of the 13 patients discontinued their TKI therapy 6 weeks (range 2 to 5 weeks) prior to conception. The rest of the 13 patients discontinued their TKI therapy at a gestational age of 4 weeks (range 2-5 weeks) after their pregnancy was ascertained. Sixteen out of the 17 patients went through their deliveries without any mishaps whilst one suffered from an unconstrained abortion. Molecular response 2 was lost by 8 of the patients after halting TKIs, whereas 10 patients lost MMR, and 3 ended up losing total hematological response. The attainment of MR4 (p=0.030), MR4.5 (p=0.031), complete cytogenetic response duration greater than or equal to 3.5 years (p=0.049), and MMR duration greater than or equal to 3.5 years (p =0.040) was strongly correlated with the lengthier MMR-failure-free survival during the TKI interruption. The correlation was demonstrated by log-rank analyses.
It may be realistic for female patients diagnosed with CML and receiving TKIs to go through planned pregnancies. Maintaining MMR during the pregnancy was largely affected by and connected to getting a deep molecular response and MMR duration greater than or equal to 3.5 years.
Link:theoncologist.onlinelibrary.wiley.com/doi/10.1634/theoncologist.2019-0109
