[使用干扰素 α 成功治疗中断酪氨酸激酶抑制剂后分子复发的慢性髓性白血病]。

Aya Shodai, Yukiko Tazaki, Natsuko Uchida, Tomonori Hamada, Rika Akahoshi, Takuya Ueno, Tomohisa Tabuchi, Naosuke Arima, Maiko Hayashida, Akihiko Arai, Daisuke Nakamura, Makoto Yoshimitsu, Hiroaki Kobayashi, Kenji Ishitsuka
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引用次数: 0

摘要

患者是一名 35 岁女性,22 岁时被诊断出患有慢性髓性白血病,当时使用的是酪氨酸激酶抑制剂(TKI)。由于获得了四年的深度分子反应(DMR),她计划在停用 TKI 后自然怀孕。尽管在确认怀孕时她的病情已发展到 MR2.0,但在停止 TKI 治疗 2 个月后,还是根据患者的病史开始了干扰素 α 治疗。后来,患者的 MR 达到了 3.0,生下了一个健康的婴儿,并将 MR 维持在 3.0-4.0。哺乳约 6 个月后,TKI 恢复治疗。尽管 BCR::ABL1 TKIs 有致畸和流产风险,但自然受孕需要无治疗缓解(TFR)。在计划怀孕时,还需要考虑患者的背景、疾病状态和病史。
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[Successful delivery using interferon α for molecular relapse of chronic myeloid leukemia after interruption of tyrosine kinase inhibitor].

A tyrosine kinase inhibitor (TKI) was used to treat the patient, a 35-year-old woman who was diagnosed with chronic myeloid leukemia at the age of 22 years. Since a four-year deep molecular response (DMR) was obtained, spontaneous pregnancy was planned under TKI withdrawal. Even though her disease had advanced to MR2.0 at the time of pregnancy confirmation, 2 months from TKI cessation, interferon α therapy was initiated in light of the patient's history. Later, the patient reached MR3.0, gave birth to a healthy baby, and maintained MR3.0-4.0. TKI was resumed after about 6 months of breastfeeding. Treatment-free remission (TFR) is required for natural conception despite the teratogenicity and miscarriage risks associated with BCR::ABL1 TKIs. When planning a pregnancy, it is also necessary to take the patients' backgrounds, disease states, and medical history into account.

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