Planned Pregnancy for a Patient with Chronic Myeloid Leukemia

Abstract

Management of chronic myeloid leukemia (CML) during pregnancy can be difficult for patients, their families and care providers. Treatment of CML and pregnancy remains a clinical challenge. Current recommendations, for women of childbearing potential, are to use adequate contraception and avoid pregnancy while taking kinase inhibitors. Consequences of exposure to kinase inhibitors to a fetus during pregnancy are unknown. Treatment may result in an increased risk of serious fetal abnormalities or spontaneous abortion. Lack of treatment for CML, during a pregnancy, may result in disease progression. In the absence of detailed information, difficulty arises to guide this patient through a decision making process. Patients who wish to interrupt therapy and become pregnant should receive intense counseling for both parents, using the most recent data available. Decisions concerning patients with CML and pregnancies must be based on individual cases. This report describes a 25 year old woman with newly diagnosed CML who purposefully arranged harvesting and storage of her unfertilized ova, prior to commencing bosutinib chemotherapy for CML