1090P - Pregnancy outcome in chronic myeloid leukemia patients on imatinib therapy

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Leukaemia
Cancer in Pregnancy
Presenter Srikant Shankar
Authors S. Shankar1, S. Dasgupta2, S. Mukhopadhyay3, D. Bhattacharya(majumdar)4, F.H. Gharami5, S. Koner5, U.K. Roy6, J. Basak4, A. Mukhopadhyay7
  • 1Medical Oncology, Netaji Subhas Chandra Bose Cancer Research Institute, 700016 - Kolkata/IN
  • 2Dept Of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute, 700016 - Kolkata/IN
  • 3Dept Of Molecular Biology, Netaji Subhash Chandra Bose Cancer Research Institute, 700016 - Kolkata/IN
  • 4Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute, 700016 - Kolkata/IN
  • 5Clinical Reseach, Netaji Subhas Chandra Bose Cancer Research Institute, 700016 - Kolkata/IN
  • 6Clinical Pathology, Netaji Subhas Chandra Bose Cancer Research Institute, 700016 - Kolkata/IN
  • 7Dept. Medical Oncology, Netaji Subhas Chandra Bose Cancer Research Institute, 700016 - Kolkata/IN

Abstract

Objective

Now that imatinib is being used to treat thousands of chronic myeloid leukemia (CML) patients for more than 10 year it is highly probable that many patients will get pregnant during its use. Company warns against any such use. But the fact remains that there is need for planned pregnancies in indicated cases. So we selected few cases both male and female for such pregnancies by interrupting treatment and following the pregnancy closely. Their outcome was studied so that we have an idea about what best could be suggested in such instance.

Patients

From November 2002 to May 2010, 634 patients with CML in any stage of the disease were treated with imatinib at our tertiary cancer research institute. Among them 274 were female and 221 were of 17 to 50 years age group. We report information of 8 accidental pregnancies and 10 planned pregnancies involving 18 patients (10 females and 8 males) who conceived while receiving imatinib for the treatment of CML.

Observations

Among 10 pregnancies reported in female sufferers there were two spontaneous and one elective abortion all in unplanned group and seven live births including one twin. There was one case of hypospadius which could be surgically corrected. Among the eight male patients whose wives conceived four pregnancies were planned, there was one spontaneous abortion, two elective abortions. The conceptions resulted in the birth of five healthy babies (two females). There was no other identifiable congenital anomaly.

Discussion

In the patients, who do become pregnant while on treatment, balancing the risk to the fetus of continuing imatinib versus the risk to the mother of interrupting treatment remains difficult. From the fetal perspective, imatinib should be discontinued due to the potential risk of serious developmental abnormalities; from the maternal perspective also there is chance of drug interruption induced cytogenetic relapse. In conclusion, exposure to imatinib during pregnancy might result in an increased risk of serious fetal abnormalities or spontaneous abortion. Women and men (pregnant wife of male patient) with childbearing potential should use adequate contraception while taking imatinib.

Disclosure

All authors have declared no conflicts of interest.