Originally published as JCO Early Release 10.1200/JCO.2005.04.6557 on January 30 2006

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ault, P. Articles by Cortes, J. Search for Related Content PubMed PubMed Citation Articles by Ault, P. Articles by Cortes, J.

Pregnancy Among Patients With Chronic Myeloid Leukemia Treated With Imatinib

From the Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX

Address reprint requests to Jorge E. Cortes, MD, Department of Leukemia, M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 428, Houston, TX 77030; e-mail: jcortes{at}mdanderson.org

PURPOSE: Imatinib has potential teratogenicity in animals, but the effect of exposure to imatinib during conception and pregnancy in humans is not known.

PATIENTS AND METHODS: The records of all patients with chronic myeloid leukemia (CML) treated with imatinib were reviewed. We report the experience on 19 pregnancies involving 18 patients (10 females and eight males) who conceived while receiving imatinib for the treatment of CML.

RESULTS: All female patients discontinued therapy immediately on recognition of pregnancy. Three pregnancies (involving two female patients and one male patient) ended in spontaneous abortion, and one patient had an elective abortion. All other pregnancies were uneventful. Two of the 16 babies had minor abnormalities at or shortly after birth (hypospadias in one baby and rotation of small intestine in one baby) that were surgically repaired. All babies have continued normal growth and development. Among female patients who interrupted therapy, five of nine in complete hematologic remission (CHR) at the time of treatment interruption eventually lost CHR, and six experienced an increase in Philadelphia chromosome–positive metaphases. At a median of 18 months after resuming therapy with imatinib, eight patients had a cytogenetic response (complete in three patients).

CONCLUSION: Although there is no evidence that a brief exposure to imatinib during conception and pregnancy adversely affects the developing fetus, most patients lose their response after treatment interruption. Patients receiving imatinib should be advised to practice adequate contraception.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

This article has been cited by other articles:

				S. M. Pye, J. Cortes, P. Ault, A. Hatfield, H. Kantarjian, R. Pilot, G. Rosti, and J. F. Apperley The effects of imatinib on pregnancy outcome Blood, June 15, 2008; 111(12): 5505 - 5508. [Abstract] [Full Text] [PDF]

				C. Christopoulos, V. Dimakopoulou, and E. Rotas Primary Ovarian Insufficiency Associated with Imatinib Therapy N. Engl. J. Med., March 6, 2008; 358(10): 1079 - 1080. [Full Text] [PDF]

				J. M. Goldman How I treat chronic myeloid leukemia in the imatinib era Blood, October 15, 2007; 110(8): 2828 - 2837. [Abstract] [Full Text] [PDF]

				C. A. Schiffer BCR-ABL Tyrosine Kinase Inhibitors for Chronic Myelogenous Leukemia N. Engl. J. Med., July 19, 2007; 357(3): 258 - 265. [Full Text] [PDF]

				K. R. McCrae, D. C. Matthews, and M. Linenberger Consultative hematology ASH Self-Assessment Program, January 1, 2007; 2007(1): 466 - 505. [Full Text] [PDF]

				R. Ali, F. Ozkalemkas, T. Ozcelik, V. Ozkocaman, and A. Ozkan Imatinib and Pregnancy J. Clin. Oncol., August 10, 2006; 24(23): 3812 - 3813. [Full Text] [PDF]