Project 9: Pregnancy in Chronic myeloproliferative diseases (CMPD)
The management of pregnant patients with essential thrombocythemia (ET) and polycythemia vera (PV) may be problematic. In the literature there are about 300 cases of pregnancies reported in ET and less than 50 pregnancies reported in PV. To reduce the effect of reporting bias we selected papers with either > 10 pregnancies or at least 6 patients and here report on the outcome of 195 pregnancies in ET and 36 pregnancies in PV patients. The live birth rate is approximately 60 % in ET and 58% in PV. Spontaneous abortion during the first trimester is the most frequent fetal complication occurring in 31% of ET pregnancies and in 22 % of PV pregnancies, respectively. Major maternal complications are more frequent in PV compared with ET (44.4% versus 7,7%). Treatment with low dose aspirin during pregnancy in ET seems to reduce complications and also seems beneficial during pregnancy in PV. In high risk pregnancies the additional use of low molecular weight heparin and/or interferon alpha should be considered. In this paper we also present a registry for an observational study concerning pregnancy in chronic Philadelphia negative myeloproliferative disorders within the European LeukemiaNet. We also provide a potential management algorithm for pregnancies in ET or PV.
Pregnancy in patients with Philadelphia negative chronic myeloproliferative disorders
Essential thrombocythemia/Polycythemia vera and pregnancy: the need for a observational study in Europe
Martin Griesshammer, Sabine Struve, Claire Harrison