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General Updates | Approaching the management of MPNs in pregnant patients
Daan Dierickx, MD, PhD, KU Leuven and University Hospitals Leuven, Leuven, Belgium, discusses the management of myeloproliferative neoplasms (MPNs) during pregnancy, highlighting the importance of low-dose aspirin to mitigate thrombotic risk. In patients with chronic myeloid leukemia (CML), the tyrosine kinase inhibitors imatinib and nilotinib can be safely administered from the second trimester onward, whereas dasatinib should not be used due to placental transfer. This interview took place virtually.
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Transcript
So the myeloproliferative neoplasms, they have the highest risk is, also in non-pregnant patients, is the thrombotic risk. So those patients need low dose aspirin. So we give them to all patients unless it’s a contraindication. The classical chemotherapy, the low-dose chemotherapy, the hydroxyurea, is not recommended, but it’s mostly also not necessary in those patients...
So the myeloproliferative neoplasms, they have the highest risk is, also in non-pregnant patients, is the thrombotic risk. So those patients need low dose aspirin. So we give them to all patients unless it’s a contraindication. The classical chemotherapy, the low-dose chemotherapy, the hydroxyurea, is not recommended, but it’s mostly also not necessary in those patients. So, for example, if there is a young patient with polycythemia, you can do venesections to bridge the pregnancy. But the most important in myeloproliferative neoplasms is to give low-dose aspirin. In CML, which is also a myeloproliferative neoplasm, so the chronic myeloid leukemia, we can give some tyrosine kinase inhibitors. So imatinib and nilotinib are safe from the second trimester on, whereas, for example, dasatinib is not safe because it’s transferred through the placenta.
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