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Interferon therapy for pregnant patients with essential thrombocythemia in Japan

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Abstract

Essential thrombocythemia (ET) mainly affects the elderly, but can also develop in women of childbearing age. The risk of miscarriage and other complications during pregnancy in ET patients are reported to be higher than that compared to the general population. Therefore, management of pregnancy in ET patients requires special considerations. Several groups recommend interferon (IFN) therapy for ET patients with high-risk pregnancies, but currently no guidelines are available in Japan. We report the outcomes of nine ET patients with ten consecutive high-risk pregnancies. All patients were successfully managed with IFN-α during their pregnancies. All patients also received aspirin and switched to unfractionated heparin around 36 weeks of gestation. As for the seven pregnancies in which IFN-α was started after detection of pregnancy, median platelet counts decreased from 910 to 573 × 109/L after 2 months of IFN-α therapy, and median platelet counts at the time of delivery for all ten pregnancies was 361 × 109/L. All patients gave birth to healthy children. IFN-α was well tolerated, safe, and effective as a cytoreductive therapy for all patients. Although evidence is limited and the use of IFN is not approved in Japan, we suggest considering IFN therapy for high-risk ET pregnancies.

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Acknowledgements

We thank the members of Department of Hematology and Department of Obstetrics and Gynecology of Juntendo University School of Medicine.

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Authors and Affiliations

  1. Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan

    Yoko Edahiro, Hajime Yasuda, Akihiko Gotoh, Jun Ando, Miyuki Tsutsui & Norio Komatsu

  2. Department of Hematology, Tokyo Medical University, Tokyo, Japan

    Akihiko Gotoh

  3. Department of Transfusion Medicine and Stem Cell Regulation, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Soji Morishita

  4. Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan

    Toshifumi Suzuki, Jun Takeda & Atsuo Itakura

  5. Department of Obstetrics and Gynecology, Keiai Hospital, Saitama, Japan

    Toshifumi Suzuki

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  1. Yoko Edahiro
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  2. Hajime Yasuda
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Correspondence to Norio Komatsu.

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12185_2020_3001_MOESM1_ESM.pdf

Supplementary file1 Supplementary Figure 1. Transition of platelet counts, white blood cell counts, and hemoglobin levels in two representative patients. Patient 5, who did not require IFN-α dose escalation (A) and patient 2, who required IFN-α dose escalation (B). Plt platelet, WBC white blood cell, Hb hemoglobin (PDF 115 kb)

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Edahiro, Y., Yasuda, H., Gotoh, A. et al. Interferon therapy for pregnant patients with essential thrombocythemia in Japan. Int J Hematol 113, 106–111 (2021). https://doi.org/10.1007/s12185-020-03001-w

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