Basauri GL, Jimenes CD, Cayoja VI, Vázquez GM, Campos PI, Olaya NA, Rincones MD, Cervantes DM, Vázquez ZD, Olaya VA

Language: Spanish
References: 10
Page: 638-641
PDF size: 199.03 Kb.

ABSTRACT

Introduction: The introduction of target therapies such as Imatinib mesylate, the first of the tyrosine kinase inhibitors in clinical practice, has drastically changed the prognosis of patients with chronic granulocytic leukemia and other types of cancers; however, its teratogenic risk is high based on its mechanism of action, as shown by studies in murine models, although its teratogenic capacity is not clear in humans.
Case report: We describe the case of a 16-year-old adolescent girl diagnosed with chronic granulocytic leukemia with treatment based on Imatinib Mesylate, which was administered during the entire pregnancy, without the newborn showing any teratogenic effect. The patient presented a threat of pre-term delivery, for which reason it was necessary to interrupt the pregnancy in the 34th week of gestation, obtaining a hypo trophic product, with good general condition and adequate development during 2 years of follow-up.
Conclusions: Although in this case no teratogenic effect on the product of the pregnancy is described during the pregnancy and its extrauterine follow-up, it is recommended that all adolescents use a contraceptive method during treatment with this type of target therapy due to the potential of its mechanism of action to affect embryogenesis, as well as in the case of programmed pregnancies to wait until the patient is 48 months old with complete molecular remission.

REFERENCES

1. Abruzzese E, Trawinska MM, Perrotti AP, De Fabrittis P. Tyrosinekinase inhibitors and pregnancy. Mediterr J HematolInfect Dis. 2014;6(1):e2014028.

2. Hasford J, Pfirrmann M, Hochhaus A. How long will chronicmyeloid leukemia patients treated with Imatinib mesylatelive? Leukemia. 2005;19(4):497–9.

3. Athale U, Hijiya N, Patterson BC, Bergsagel J, AndolinaJR, Bittencourt H, et al. Management of chronic myeloidleukemia in children and adolescents: Recommendationsfrom the Children’s Oncology Group CML Working Group.Pediatr Blood Cancer. 2019;66(9):e27827.

4. Motohiro T. Successful Pregnancy in a Patient with ChronicMyeloid Leukemia under Treatment with Imatinib. InteerMed. 2009

5. Zuazu J, Julia A, Sierra J, Valentin MG, Coma A, Sanz MA,et al. Pregnancy outcome in hematologic malignancies.Cancer. 1991;67(3):703–9.

6. Pye SM, Cortes J, Ault P, Hatfield A, Kantarjian H, Pilot R,et al. The effects of Imatinib on pregnancy outcome. Blood.2008;111(12):5505–8.

7. Manning G, Whyte DB, Martínez R, hunter T, SudarsanamS. The protein kinase complement of the human genome.Science. 2002;298:1912-1934

8. Abruzzese E, Mauro M, Apperley J, Chelysheva E. Tyrosinekinase inhibitors and pregnancy in chronic myeloid leukemia:opinion, evidence, and recommendations. Ther AdvHematol. 2020;11:2040620720966120

9. Gambacorti-Passerini CB, Tornaghi L, Marangon E, FranceschinoA, Pogliani EM, D’Incalci M, et al. Imatinib concentrationsin human milk. Blood. 2007;109(4):1790-1790.

10. Aguerre L, MB. Leucemia mieloide crónica y embarazo enla era de las terapias blanco-moleculares. Hematología20 (3): 323 - 333.