Pegylated interferon alpha-2a for essential thrombocythemia during pregnancy: outcome and safety. A case series

Risk of venous thromboembolism in pregnant women with essential thrombocythemia: a systematic review and meta-analysis

“…Among the 16 studies that reported VTE outcomes and IFN use during pregnancy, there were 0 antepartum VTE events among 38 pregnancies with IFN use (0%; 95% CI, 0.0-11.9; I 2 0%), and 3 antepartum VTE events among 266 pregnancies without IFN use (2.0%; 95% CI, 0.7-3.9; I 2 0%). 6,[14][15][16][17][18][19][20][21][22][23]25,[28][29][30][31] Of the 38 pregnancies with IFN use: 14 received LMWH, 14 received no LMWH, and 10 had unknown LMWH use. Of the 266 pregnancies without IFN: 30 received LMWH, 156 received no LMWH, and 80 had unknown LMWH use.…”

“…Of the 18 studies that reported VTE outcomes and antepartum LMWH prophylaxis use, there were 0 antepartum VTE events among 82 pregnancies with LMWH use (0%; 95% CI, 0.0-5.7; I 2 0%), and 8 antepartum VTE events among 407 pregnancies without LMWH use (2.5%; 95% CI, 1.3-4.3; I 2 0%) ( Table 2). [4][5][6][7][14][15][16][17][18][19][20][21][22][23]25,[28][29][30][31] Among the 18 studies that reported VTE outcomes and ASA use during pregnancy, there were 6 antepartum VTE events among 283 pregnancies with ASA use (2.9%; 95% CI, 1.3-5.1; I 2 0%), and 2 antepartum VTE events among 158 pregnancies without ASA use (2.8%; 95% CI, 0.9-5.8; I 2 0%). Of the subgroup of 212 pregnancies reported in which ASA was used alone without LMWH, there were 6 antepartum VTE events (4.2%; 95% CI, 2.0-7.1; I 2 0%).…”

Patients with essential thrombocytosis during pregnancy: Challenges and therapeutic dilemmas

“…There were significantly more live births on peg-IFN and fewer miscarriages. When LMWH was added to treatment there was a trend towards a better outcome even not statistically significant [19]. In addition, another successful high-risk pregnancy has been reported under treatment with Peg-IFN combined with ASA and LMWH.…”

“…Due to the increased percentage of abortions and pregnancy complications in untreated patients as results of thrombosis and abnormal placenta blood circulation, the addition of low-dose ASA showed encouraging results. There are reports in patients with a history of abortions that had a successful pregnancy after single treatment with ASA [5,6,8,9,16,[19][20][21][22][23][24][25]. ASA was also initiated in some cases, if not at the beginning of pregnancy, when a pregnancy complication was present like hypertension disorders, abrutio placenta or IUGR and premature delivery [5,8,[25][26][27].…”

NCCN Guidelines Insights: Myeloproliferative Neoplasms, Version 2.2018

“…Interferons (interferon alfa-2b, peginterferon alfa-2a, and peginterferon alfa-2b) should be considered if cytoreductive therapy is necessary. 62,69,70 Hydroxyurea is excreted in breastmilk and should be avoided in women who are breastfeeding. Patients on hydroxyurea before pregnancy should be switched to interferons.…”