Stefania Stella1,2, Elena Tirró3,2, Michele Massimino3,2, Silvia Rita Vitale3,2, Sabina Russo4, Maria Stella Pennisi3,2, Adriana Puma3,2, Chiara Romano3,2, Sandra DI Gregorio3,2, Vanessa Innao4, Fabio Stagno5, Francesco DI Raimondo5,6, Caterina Musolino4, Livia Manzella3,2. 1. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy stefania.stel@gmail.com. 2. Center of Experimental Oncology and Hematology, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy. 3. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy. 4. Division of Hematology, University of Messina, Messina, Italy. 5. Division of Hematology and Bone Marrow Transplant, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy. 6. Department of Surgery, Medical and Surgical Specialities, University of Catania, Catania, Italy.
Abstract
BACKGROUND/AIM: As approximately 10% of individuals developing chronic myeloid leukemia (CML) are females aged 20-44 years, a considerable number will consider a planned pregnancy if disease is well controlled by pharmacological treatment. The management of these young patients during pregnancy represents a therapeutic dilemma due to the potential teratogen effects of several tyrosine kinase inhibitors (TKIs) and is a matter of continuous debate. Indeed, despite the existence of several studies, there is currently no consensus on how to manage different pregnancy situations in subjects with CML. PATIENTS AND METHODS: We describe a female patient diagnosed with Ph-positive CML one month after her first delivery who achieved excellent hematological, cytogenetic and molecular responses while on imatinib mesylate (IM) treatment. RESULTS: The excellent responses allowed the patient to suspend TKI treatment in order to plan a second pregnancy. Despite IM discontinuation, stringent molecular monitoring of her BCR-ABL1/ABL1 levels allowed the safe delivery of the child and, while the patient eventually developed a molecular relapse after four years of treatment discontinuation, upon restarting IM she quickly regained a deep molecular response that is still ongoing. CONCLUSION: Our case report demonstrates that, if the pregnancy is properly planned in CML patients, it can result in excellent management of the clinical therapeutic option for the benefit of both mother and child. Copyright
BACKGROUND/AIM: As approximately 10% of individuals developing chronic myeloid leukemia (CML) are females aged 20-44 years, a considerable number will consider a planned pregnancy if disease is well controlled by pharmacological treatment. The management of these young patients during pregnancy represents a therapeutic dilemma due to the potential teratogen effects of several tyrosine kinase inhibitors (TKIs) and is a matter of continuous debate. Indeed, despite the existence of several studies, there is currently no consensus on how to manage different pregnancy situations in subjects with CML. PATIENTS AND METHODS: We describe a female patient diagnosed with Ph-positive CML one month after her first delivery who achieved excellent hematological, cytogenetic and molecular responses while on imatinib mesylate (IM) treatment. RESULTS: The excellent responses allowed the patient to suspend TKI treatment in order to plan a second pregnancy. Despite IM discontinuation, stringent molecular monitoring of her BCR-ABL1/ABL1 levels allowed the safe delivery of the child and, while the patient eventually developed a molecular relapse after four years of treatment discontinuation, upon restarting IM she quickly regained a deep molecular response that is still ongoing. CONCLUSION: Our case report demonstrates that, if the pregnancy is properly planned in CMLpatients, it can result in excellent management of the clinical therapeutic option for the benefit of both mother and child. Copyright
Authors: C Giallongo; D Tibullo; P La Cava; A Branca; N Parrinello; P Spina; F Stagno; C Conticello; A Chiarenza; P Vigneri; G A Palumbo; F Di Raimondo Journal: Acta Haematol Date: 2011-09-16 Impact factor: 2.195
Authors: Michele Massimino; Maria Letizia Consoli; Maria Mesuraca; Fabio Stagno; Elena Tirrò; Stefania Stella; Maria Stella Pennisi; Chiara Romano; Pietro Buffa; Heather M Bond; Giovanni Morrone; Laura Sciacca; Francesco Di Raimondo; Livia Manzella; Paolo Vigneri Journal: Carcinogenesis Date: 2014-01-20 Impact factor: 4.944
Authors: Livia Manzella; Elena Tirrò; Silvia Rita Vitale; Adriana Puma; Maria Letizia Consoli; Loredana Tambè; Maria Stella Pennisi; Sandra DI Gregorio; Chiara Romano; Cristina Tomarchio; Francesco DI Raimondo; Fabio Stagno Journal: In Vivo Date: 2020 May-Jun Impact factor: 2.155