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MPN Workshop of the Carolinas 2024 | Key considerations for physicians when faced with a pregnant patient with MPN
Gaby Hobbs, MD, Massachusetts General Hospital, Boston, MA, underlines key considerations for physicians when faced with a pregnant patient with myeloproliferative neoplasms (MPN). Dr Hobbs suggests changes to cytoreduction and the introduction of aspirin and low molecular weight heparin during different stages of pregnancy and highlights the importance of collaborating with an obstetrician to monitor patients. This interview took place at the 1st Annual MPN Workshop of the Carolinas in Asheville, NC.
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Transcript
I think the first thing to remember is that patients that are pregnant with an MPN are going to be, by definition, young. And so most of those patients, although they may have abnormal blood counts, those abnormal blood counts are not an indication for being on cytoreduction.
So oftentimes when I encounter a patient that’s considering pregnancy, really what I end up doing is taking them off of their cytoreduction because oftentimes they come to me on hydroxyurea...
I think the first thing to remember is that patients that are pregnant with an MPN are going to be, by definition, young. And so most of those patients, although they may have abnormal blood counts, those abnormal blood counts are not an indication for being on cytoreduction.
So oftentimes when I encounter a patient that’s considering pregnancy, really what I end up doing is taking them off of their cytoreduction because oftentimes they come to me on hydroxyurea. Once the patient is pregnant, I think the most important consideration is to remember that those patients need to be kept on aspirin, and if they’re not on aspirin, they need to be started on aspirin. This is particularly relevant for those patients that are very young with a Calreticulin mutation that maybe wouldn’t be on aspirin before pregnancy.
And the other is to try to establish a relationship with a high-risk OB provider so that they can help monitor those patients.
And then lastly, although we think of pregnancy as a high thrombotic risk, really it’s the postpartum period that’s the highest risk of thrombosis and that’s a period of time where patients need to be on low molecular weight heparin.
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Disclosures
Consultancy: Abbvie, BMS, GSK, Novartis, Pfizer, Pharmaessentia, Incyte.
