Pregnancy and myeloproliferative neoplasms : A retrospective monocentric cohort

Puyade, Mathieu; Cayssials, Émilie; Pierre, Fabrice H.F.; Pourrât, O.

doi:10.1177/1753495x17708896

Cited by 11 publications

(20 citation statements)

References 24 publications

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“…Special attention was given in the beneficial role of ASA when was given in patients with known ET, which was continued throughout pregnancy. ASA appeared to increase the percentage of live births with less pregnancy complications [5,8,9].…”

Section: No Treatmentmentioning

confidence: 91%

“…However, an increased percentage of abortions were reported [5][6][7][8] and also of pregnancy complications including intrauterine growth retardation (IUGR) [9], placenta abruption [8], preterm delivery [5,8,10,11] and intrauterine fetal death [9]. Moreover, for undiagnosed patients, the outcome was worse in comparison in future pregnancies when ET was treated [9].…”

Section: No Treatmentmentioning

confidence: 99%

“…Moreover, for undiagnosed patients, the outcome was worse in comparison in future pregnancies when ET was treated [9]. Special attention was given in the beneficial role of ASA when was given in patients with known ET, which was continued throughout pregnancy.…”

Section: No Treatmentmentioning

confidence: 99%

“…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].…”

Section: Low Dose Aspirin and Other Antiplatelet Agentsmentioning

confidence: 99%

“…There are reports where LMWH was given [8,9]. LMWH was also given when ASA was contraindicated due to increased risk of bleeding.…”

Section: Low Molecular Weight Heparinmentioning

confidence: 99%

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Patients with essential thrombocytosis during pregnancy: Challenges and therapeutic dilemmas

Kanellopoulou¹

2017

Obstet Gynecol Rep

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Treatment of patients with essential thrombocytosis during pregnancy is challenging and young women are reported to be at increased risk of first trimester abortions and other pregnancy complications. In literature, there are case reports and small case series where the treatment approach differs and the results are conflicting. The addition of low dose aspirin seems to be beneficial in most cases improving pregnancy outcome whereas interferon-a is the cytoreductive drug of choice when platelet control is needed during pregnancy. Anticoagulation with low-molecular weight heparin is not generally recommended and should be considered during the last few weeks of pregnancy and postpartum.

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Section: No Treatmentmentioning

confidence: 91%

Section: No Treatmentmentioning

confidence: 99%

Section: No Treatmentmentioning

confidence: 99%

Section: Low Dose Aspirin and Other Antiplatelet Agentsmentioning

confidence: 99%

“…There are reports where LMWH was given [8,9]. LMWH was also given when ASA was contraindicated due to increased risk of bleeding.…”

Section: Low Molecular Weight Heparinmentioning

confidence: 99%

See 3 more Smart Citations

Patients with essential thrombocytosis during pregnancy: Challenges and therapeutic dilemmas

Kanellopoulou¹

2017

Obstet Gynecol Rep

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Association of Treatments for Myeloproliferative Neoplasms During Pregnancy With Birth Rates and Maternal Outcomes

et al. 2019

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Key PointsQuestionAre use of aspirin, heparin, interferon, or combinations associated with live birth rate and adverse maternal outcomes in pregnant women with myeloproliferative neoplasms?FindingsIn this systematic review and meta-analysis of 22 studies, reporting on 1210 pregnancies, the live birth rate was 71.3%; most studies reported on pregnancy with essential thrombocythemia. The use of aspirin and interferon—but not heparin—was associated with higher odds of live birth.MeaningModerate-quality evidence suggests that treatment with aspirin or interferon is associated with higher odds of live birth in pregnant patients with myeloproliferative neoplasms.

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Myeloproliferative neoplasms and pregnancy: Overview and practice recommendations

Gangat

Tefferi

2020

American J Hematol

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Pregnancy in the context of myeloproliferative neoplasms (MPN) poses unique fetal and maternal challenges. Current literature in this regard mostly involves essential thrombocythemia (ET) and less so polycythemia vera (PV) or myelofibrosis. In ET, live birth rate is estimated at 70% with first trimester fetal loss (˜ 30%) as the major complication. Risk of pregnancy‐associated complications is higher in PV, thus mandating a more aggressive treatment approach. Herein, we appraise the relevant literature, share our own experience and propose management recommendations. Aspirin therapy may offer protection against fetal loss; however the additive benefit of systemic anticoagulation or cytoreductive therapy, in the absence of high risk disease, is unclear. We recommend cytoreductive therapy in the form of interferon alpha in all high risk and select low‐risk ET and PV patients with history of recurrent fetal loss, prominent splenomegaly or suboptimal hematocrit control with phlebotomy. In addition, all women with PV should maintain strict hematocrit control <45% with the aid of phlebotomy. Systemic anticoagulation with low molecular weight heparin is advised in patients with history of venous thrombosis. Further clarification awaits prospective clinical trials that implement risk adapted therapeutic interventions.

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Pregnancy and myeloproliferative neoplasms : A retrospective monocentric cohort

Abstract: Thrombocytosis associated with myeloproliferative neoplasms should be considered as a risk factor for maternal and fetal complications.

Cited by 11 publications

References 24 publications

Patients with essential thrombocytosis during pregnancy: Challenges and therapeutic dilemmas

Patients with essential thrombocytosis during pregnancy: Challenges and therapeutic dilemmas

Association of Treatments for Myeloproliferative Neoplasms During Pregnancy With Birth Rates and Maternal Outcomes

Myeloproliferative neoplasms and pregnancy: Overview and practice recommendations

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