BCR-ABL inhibitors administered in conjunction with chemotherapy have significantly improved outcomes in Philadelphia chromosome-positive acute lymphoblastic leukemia but, for patients diagnosed during pregnancy, data on risks to the fetus are limited. We report a woman treated with chemotherapy and imatinib mesylate who delivered a healthy baby at 30 weeks, and we discuss available data.
ManciniMNanniMSirletoP. Detection of BCR/ABL rearrangements in adult acute lymphoblastic leukemia using a highly sensitive interphase fluorescence in situ hybridization method (D-FISH). Hematol J2001; 2: 54–60.
2.
WestbrookCAHoobermanALSpinoC. Clinical significance of the BCR-ABL fusion gene in adult acute lymphoblastic leukemia: a cancer and leukemia group B study (8762). Blood1992; 80: 2983–2990.
3.
PretiHAO'BrienSGiraltS. Philadelphia-chromosome-positive adult acute lymphocytic leukemia: characteristics, treatment results, and prognosis in 41 patients. Am J Med1994; 97: 60–65.
4.
KantarjianHMO'BrienSSmithTL. Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol2000; 18: 547–561.
5.
FormanSJO'DonnellMRNademaneeAP. Bone marrow transplantation for patients with philadelphia chromosome-positive acute lymphoblastic leukemia. Blood1987; 70: 587–588.
6.
GleissnerBGokbugetNBartramCR. Leading prognostic relevance of the BCR-ABL translocation in adult acute B-lineage lymphoblastic leukemia: a prospective study of the German Multicenter Trial Group and confirmed polymerase chain reaction analysis. Blood2002; 99: 1536–1543.
7.
NashedALRaoKWGulleyML. Clinical applications of BCR-ABL molecular testing in acute leukemia. J Mol Diagn2003; 5: 63–72.
8.
LeeHJThompsonJEWangES. Philadelphia chromosome-positive acute lymphoblastic leukemia: current treatment and future perspectives. Cancer2011; 117: 1583–1594.
9.
LeeKHLeeJHChoiSJ. Clinical effect of imatinib added to intensive combination chemotherapy for newly diagnosed philadelphia chromosome-positive acute lymphoblastic leukemia. Leukemia2005; 19: 1509–1516.
10.
WassmannBPfeiferHGoekbugetN. Alternating versus concurrent schedules of imatinib and chemotherapy as front-line therapy for philadelphia-positive acute lymphoblastic leukemia (ph+ ALL). Blood2006; 108: 1469–1477.
11.
FieldingAK. Current treatment of Philadelphia chromosome–positive acute lymphoblastic leukemia. ASH Educ Program Book2011; 1: 231–237.
12.
ThomasDAFaderlSCortesJ. Treatment of Philadelphia chromosome-positive acute lymphocytic leukemia with hyper-CVAD and imatinibmesylate. Blood2004; 103: 4396–4407.
13.
ChelghoumYVeyNRaffouxE. Acute leukemia during pregnancy: a report on 37 patients and a review of the literature. Cancer2005; 104: 110–117.
14.
ShapiraTPeregDLishnerM. How I treat acute and chronic leukemia in pregnancy. Blood Rev2008; 22: 247–259.
15.
CardonickEIacobucciA. Use of chemotherapy during human pregnancy. Lancet Oncol2004; 5: 283–291.
16.
AmantFVan CalsterenKHalaskaMJ. Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study. Lancet Oncol2012; 13: 256–264.
17.
AvilesANeriN. Hematological malignancies and pregnancy: a final report of 84 children who received chemotherapy in utero. Clin Lymphoma2001; 2: 173–177.
18.
LloydMECarrMMcElhattonP. The effects of methotrexate on pregnancy, fertility and lactation. QJM1999; 92: 551–563.
19.
AliROzkalemkasFKimyaY. Imatinib use during pregnancy and breast feeding: a case report and review of the literature. Arch Gynecol Obstet2009; 280: 169–175.
20.
AultPKantarjianHO'BrienS. Pregnancy among patients with chronic myeloid leukemia treated with Imatinib. J Clin Oncol2006; 24: 1204–1208.
21.
PyeSMCortesJAultP. The effects of imatinib on pregnancy outcome. Blood2008; 111: 5505–5508.
22.
RussellMACarpenterMWAkhtarMS. Imatinib mesylate and metabolite concentrations in maternal blood, umbilical cord blood, placenta and breast milk. J Perinatol2007; 27: 241–243.
23.
ConchonMSanabaniSSBenditI. Two successful pregnancies in a woman with chronic myeloid leukemia exposed to nilotinib during the first trimester of her second pregnancy: case study. J Hematol Oncol2009; 2: 42–42.
24.
ConchonMSanabaniSSerpaM. Successful pregnancy and delivery in a patient with chronic myeloid leukemia while on dasatinib therapy. Adv Hematol2010; 2010: 136252–136252.
25.
NakajimaYKuwabaraHHattoriY. Successful treatment of a pregnant woman with Philadelphia chromosome-positive acute lymphoblastic leukemia. Int J Hematol2013; 97: 427–429.
26.
TickuJOberoiSFriendS. Acute lymphoblastic leukemia in pregnancy: a case report with literature review. Ther Adv Hematol2013; 4: 313–319.
