On the Children Side. Overview of 194 Outcomes from Gimema Registry of Conception/Pregnancy in Chronic Myeloid Leukemia (CML)

• Published in: Blood 2023-11, Vol.142 (Supplement 1), p.3178-3178
• Main Authors: Abruzzese, Elisabetta, Chiara, Elena, Castagnetti, Fausto, Annunziata, Mario, Gambacorti-Passerini, Carlo, Luciano, Luigiana, Russo Rossi, Antonella, Iurlo, Alessandra, Capodanno, Isabella, Giai, Valentina, D'Adda, Mariella, Stagno, Fabio, Gozzini, Antonella, Tiribelli, Mario, Sorà, Federica, Galimberti, Sara, Bocchia, Monica, Beltrami, Germana, Fava, Carmen, Miggiano, Maria Cristina, Breccia, Massimo, Cerrano, Marco, Scortechini, Anna Rita, Mulas, Olga, Caracciolo, Clementina, Impera, Stefana, Fozza, Claudio, Malato, Alessandra, Mastrullo, Lucia, Salvucci, Marzia, Lunghi, Monia, Gherlinzoni, Filippo, De Fabritiis, Paolo, Fazi, Paola, Orlando, Sonia Maria, Piciocchi, Alfonso, Pane, Fabrizio
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2023-188305

Pregnancy in patients with chronic myeloid leukemia (CML) is no longer precluded. The literature published to date has mainly evaluated the management of CML and pregnancy with little mention of follow-up of children. This work aims to focus on the effects of the disease and of the drugs taken before conception and/or during pregnancy on fertility, gestation, pre-natal development of the fetus, and the growth of the child. GIMEMA has promoted an observational retrospective/prospective study to harvest and study detailed information on both pregnancies in female CML patients and pregnancies of partners of male patients followed at participating centers. The information requested addressed information on demographic, CML- related (CML therapy before/during/after pregnancy; transcript kinetics; outcome post delivery), pregnancy-related (type of conception; abortion rate; pregnancy progression, delivery, breastfeeding), and baby-related (birth, physical, intellectual, emotional, behavioral, social and sexual development) Data from 83 male patients (109 pregnancies) and 74 female patients (84 pregnancies) were evaluated for a total of 193 pregnancies at term. Fourteen (7 female and 7 male) conceptions were medically assisted, all the others spontaneous. One hundred ninety-four children were born (a twin pregnancy), 15 abortions were registered, 12 spontaneous and 3 voluntary all within the first trimester, while one pregnancy is still in progress. Eleven patients (1 male, 10 female) were diagnosed as having CML during pregnancy. Three patients interrupted pregnancy (2 electives). All male patients, with the exception of two (one undergoing assisted reproduction and one in TFR), conceived during treatment. TKI used were Imatinib (71%), Nilotinib (22%), Dasatinib (2%), Bosutinib (4%) and Ponatinib (1%). The pregnancies carried out by the partners of the male patients did not show any problems, neither pre-conception, nor during gestation, nor at birth. An initial speech delay in a child was reported, with recovery after speech therapy. Most pregnancies result in spontaneous delivery around the 39th week of gestation. Ninety-two/109 babies were breastfed (84%) The last TKI used in the female CML group was imatinib (43%), nilotinib (33%), dasatinib (22%), and Ponatinib (2%). Most patients stopped TKI at the FPT “first pregnancy test” (3-5 weeks). Cesarean deliveries amounted to 41%, just above the national average of 30%, with a mean of 38 weeks of gestation. Of th