Lukas Schrickel1, Florian H Heidel2,3, Parvis Sadjadian4, Tatjana Becker4, Vera Kolatzki4, Andreas Hochhaus2, Martin Griesshammer4, Kai Wille4. 1. University Clinic for Haematology, Oncology, Haemostaseology and Palliative Care, Johannes Wesling Medical Center Minden, UKRUB, Ruhr-University Bochum, Minden, Germany. lukasjacob.schrickel@muehlenkreiskliniken.de. 2. Department of Internal Medicine 2, Haematology and Oncology, University Hospital Jena, Jena, Germany. 3. Internal Medicine C, University Medicine Greifswald, Greifswald, Germany. 4. University Clinic for Haematology, Oncology, Haemostaseology and Palliative Care, Johannes Wesling Medical Center Minden, UKRUB, Ruhr-University Bochum, Minden, Germany.
Abstract
PURPOSE: Pregnancies in women with essential thrombocythemia (ET) are at a higher risk for obstetrical complications. Acetylsalicylic acid (ASA) and low-molecular weight heparin (LMWH) are common options to prevent miscarriages and maternal complications, whereas interferon alpha (IFN) seems to be the cytoreductive therapy of choice. This retrospective study analyzes the largest number of IFN pregnancies to date in terms of outcome and safety. METHODS: Data of 34 high-risk pregnancies in 23 women presenting at the University hospitals of Minden and Jena from 01-Jun-2007 to 01-Jun-2020 were collected. Reasons defining high-risk ET pregnancy in all 23 patients were: Thrombosis (n = 9) or severe hemorrhage (n = 2) in history, platelet count ≥ 1500 × 103/µl (n = 8) or severe microcirculatory disturbances not completely responding to ASA (n = 4). RESULTS: Without the use of IFN, live birth rate was 60% (6/10), however, after the use of IFN live birth rate increased to 73.5% (25/34 pregnancies). Nine pregnancies ended in miscarriages (9/34; 26.5%); all of them spontaneous abortions. Live birth rate significantly improved with ASA (90% versus 50%, p = 0.0168), however, if ASA and LMWH was added (n = 14), live birth rate was 100%. IFN compound (PEGylated versus standard IFN) and JAK2-driver mutation had no impact on pregnancy outcome. One major maternal complication occurred as a major peripartal bleeding after abortion curettage. CONCLUSION: IFN was associated with an encouraging live birth rate of 73.5% with no fatal maternal events and manageable side effects.
PURPOSE: Pregnancies in women with essential thrombocythemia (ET) are at a higher risk for obstetrical complications. Acetylsalicylic acid (ASA) and low-molecular weight heparin (LMWH) are common options to prevent miscarriages and maternal complications, whereas interferon alpha (IFN) seems to be the cytoreductive therapy of choice. This retrospective study analyzes the largest number of IFN pregnancies to date in terms of outcome and safety. METHODS: Data of 34 high-risk pregnancies in 23 women presenting at the University hospitals of Minden and Jena from 01-Jun-2007 to 01-Jun-2020 were collected. Reasons defining high-risk ET pregnancy in all 23 patients were: Thrombosis (n = 9) or severe hemorrhage (n = 2) in history, platelet count ≥ 1500 × 103/µl (n = 8) or severe microcirculatory disturbances not completely responding to ASA (n = 4). RESULTS: Without the use of IFN, live birth rate was 60% (6/10), however, after the use of IFN live birth rate increased to 73.5% (25/34 pregnancies). Nine pregnancies ended in miscarriages (9/34; 26.5%); all of them spontaneous abortions. Live birth rate significantly improved with ASA (90% versus 50%, p = 0.0168), however, if ASA and LMWH was added (n = 14), live birth rate was 100%. IFN compound (PEGylated versus standard IFN) and JAK2-driver mutation had no impact on pregnancy outcome. One major maternal complication occurred as a major peripartal bleeding after abortion curettage. CONCLUSION:IFN was associated with an encouraging live birth rate of 73.5% with no fatal maternal events and manageable side effects.
Authors: R Cincotta; J R Higgins; C Tippett; E Gallery; R North; L P McMahon; S P Brennecke Journal: Aust N Z J Obstet Gynaecol Date: 2000-02 Impact factor: 2.100
Authors: Tiziano Barbui; Giovanni Barosi; Gunnar Birgegard; Francisco Cervantes; Guido Finazzi; Martin Griesshammer; Claire Harrison; Hans Carl Hasselbalch; Rudiger Hehlmann; Ronald Hoffman; Jean-Jacques Kiladjian; Nicolaus Kröger; Ruben Mesa; Mary F McMullin; Animesh Pardanani; Francesco Passamonti; Alessandro M Vannucchi; Andreas Reiter; Richard T Silver; Srdan Verstovsek; Ayalew Tefferi Journal: J Clin Oncol Date: 2011-01-04 Impact factor: 44.544
Authors: Tiziano Barbui; Ayalew Tefferi; Alessandro M Vannucchi; Francesco Passamonti; Richard T Silver; Ronald Hoffman; Srdan Verstovsek; Ruben Mesa; Jean-Jacques Kiladjian; Rȕdiger Hehlmann; Andreas Reiter; Francisco Cervantes; Claire Harrison; Mary Frances Mc Mullin; Hans Carl Hasselbalch; Steffen Koschmieder; Monia Marchetti; Andrea Bacigalupo; Guido Finazzi; Nicolaus Kroeger; Martin Griesshammer; Gunnar Birgegard; Giovanni Barosi Journal: Leukemia Date: 2018-02-27 Impact factor: 11.528