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Obstetric Complications and Management in Chronic Myeloid Leukemia

  • Minakshi Rohilla
  • Rakhi RaiEmail author
  • Uday Yanamandra
  • Neelam Chaudhary
  • Pankaj Malhotra
  • Neelam Varma
  • Vanita Jain
  • G. R. V. Prasad
  • Jasvinder Kalra
  • Subhash C. Varma
Original Article

Abstract

Chronic myeloid leukaemia (CML) is amongst the most common haematological malignancies encountered in adults. The younger age of onset and increased incidence of CML in Indians leads to higher chances of encountering it in pregnancy. Pregnancy in CML is a complex situation as first line therapy with tyrosine kinase inhibitors (TKI), is fraught with multiple fetal safety issues. The fetal aspects have been elucidated in literature, but there is scarcity of information on the obstetric outcome per se in presence of CML, excluding the influence of TKI. Obstetric outcomes of 5 pregnancies in four patients with CML are being reported. Literature on interplay of CML and bleeding or thrombotic manifestations is reviewed. The major complications encountered were antepartum (APH) and postpartum haemorrhage (PPH), preterm labour, intrauterine growth retardation and intrauterine fetal death. Patients in the reproductive age group with diagnosis of CML should be carefully counseled regarding the effect of disease and TKI on the maternal-fetal health. Bleeding complications, particularly APH and PPH may be encountered in CML patients. Close coordination of the obstetrician, haematologist, and neonatologist is required in managing these cases successfully. The need for absolute contraception till the remission of disease needs to be emphasized for further pregnancies.

Keywords

Chronic myeloid leukaemia Pregnancy Haemorrhagic obstetric complications Tyrosine kinase inhibitors 

Notes

Conflict of Interest

We declare that there is no conflict of interest.

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Copyright information

© Indian Society of Haematology & Transfusion Medicine 2015

Authors and Affiliations

  • Minakshi Rohilla
    • 1
  • Rakhi Rai
    • 1
    Email author
  • Uday Yanamandra
    • 2
  • Neelam Chaudhary
    • 1
  • Pankaj Malhotra
    • 2
  • Neelam Varma
    • 2
  • Vanita Jain
    • 1
  • G. R. V. Prasad
    • 1
  • Jasvinder Kalra
    • 1
  • Subhash C. Varma
    • 3
  1. 1.Department of Obstetrics and GynecologyPost Graduate Institute of Medical Education and Research (PGIMER)Chandigarh (U.T.)India
  2. 2.Department of HematologyPost Graduate Institute of Medical Education and Research (PGIMER)Chandigarh (U.T.)India
  3. 3.Department of Internal MedicinePost Graduate Institute of Medical Education and Research (PGIMER)Chandigarh (U.T.)India

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