The issue of pregnant women with BCR/ABL negative myeloproliferative neoplasms


Authors: J. Kissová 1;  M. Penka 1;  P. Ovesná 2;  A. Buliková 1;  R. Gerychová 3
Authors‘ workplace: Oddělení klinické hematologie Fakultní nemocnice Brno 1;  Institut biostatistiky a analýz Masarykovy univerzity Brno 2;  Gynekologicko-porodnická klinika Fakultní nemocnice Brno a Lékařská fakulta Masarykovy univerzity Brno 3
Published in: Transfuze Hematol. dnes,19, 2013, No. 4, p. 197-208.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

The clinical course of BCR/ABL negative myeloproliferative neoplasms is often complicated by thrombotic and to a lesser extent bleeding complications. Although these diseases are generally considered to be diseases of older age, about 20% of patients with essential thrombocythemia are under 40 years. Increasing age of pregnant women and improvement of diagnostics has led to an increased incidence of pregnancy in the course of these diseases. The incidence of pregnancy associated complications is higher compared to other pregnancies, and reproductive losses in these women are 2–3 times more frequent. The most common complications of such pregnancies are spontaneous abortion in the first trimester (25–40%) and late foetal loss (8–21%). Intrauterine foetal growth retardation, stillbirth and placental abruption are less common. These complications arise regardless of the number of platelets and occur more frequently in patients with complications during previous pregnancies and with the presence of JAK2 V617F mutation. The limited number of published data makes it difficult to get a clear view of the overall risk of these events. Therapeutic options range from the administration of aspirin, low molecular weight heparin to targeted cytoreductive depending on the given patient’s risk factors.

In this work, we evaluated retrospective data from a group of 7 women with a total number of 14 pregnancies and the diagnosis of BCR/ABL negative myeloproliferative disorders. In concurrence with published data, a higher incidence of pregnancy complications was found, especially in patients with positive JAK2 V617F mutation. The low number of pregnancies in single centres does not allow for any clear conclusions regarding both the risk factors for pregnancy complications and therapeutic recommendations. The limited data published on this issue is a call for cooperation not only at national, but also international level.

Key words:
myeloproliferative neoplasm, pregnancy, thrombocythemia, polycythemia, myelofibrosis


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Haematology Internal medicine Clinical oncology
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