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Leukemia and pregnancy

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https://www.readbyqxmd.com/read/29284357/experience-with-dasatinib-and-nilotinib-use-in-pregnancy
#1
Theodora Barkoulas, Philip D Hall
Pregnancy in a patient with chronic myeloid leukemia presents a therapeutic challenge. Both dasatinib and nilotinib are indicated for first-line treatment as well as for treatment-resistant chronic myeloid leukemia. Animal studies with dasatinib or nilotinib demonstrate fetal skeletal malformations as well as significant mortality during organogenesis. The goal of this article is to review the experience to date of dasatinib and nilotinib in human pregnancy, specifically dasatinib and nilotinib dose, length of exposure, trimester of use, as well as patient and fetal outcomes...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29230832/management-of-chronic-myeloid-leukemia-in-the-setting-of-pregnancy-when-is-leukocytapheresis-appropriate-a-case-report-and-review-of-the-literature
#2
Elizabeth M Staley, Sierra C Simmons, Alexander Z Feldman, Robin G Lorenz, Marisa B Marques, Lance A Williams, X Long Zheng, Huy P Pham
BACKGROUND: Chronic myeloid leukemia (CML) is a common hematologic malignancy; however, its occurrence during pregnancy is unusual due to its low prevalence in females of childbearing age. There are conflicting reports of how to best manage CML in pregnancy, particularly in the setting of leukocytosis. CASE REPORT: A 30-year-old female was diagnosed with CML at 18 weeks' estimated gestational age. On initial presentation she reported fatigue, night sweats, and early satiety, and was found to have a white blood cell (WBC) count of 69...
December 11, 2017: Transfusion
https://www.readbyqxmd.com/read/29225675/pregnancy-and-myeloproliferative-neoplasms-a-retrospective-monocentric-cohort
#3
Mathieu Puyade, Emilie Cayssials, Fabrice Pierre, Olivier Pourrat
Background: The most frequent myeloproliferative neoplasms are essential thrombocythemia and chronic myelogenous leukemia, which usually manifests with thrombocytosis. Only essential thrombocythemia is associated with morbidity during pregnancy (recurrent miscarriages, intrauterine fetal death, small for gestational age and preeclampsia). The aim of this paper is to describe outcomes of pregnancy in women with myeloproliferative neoplasms seen at a single academic institution. Methods: Data were collected retrospectively from 2002 to 2015...
December 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/29207935/cardiac-birth-defects-in-a-twin-infant-born-to-a-woman-with-chronic-myeloid-leukemia-on-dasatinib
#4
David J Hermel, Victor Chiu, Melody H Hermel, Anil Tulpule, Mojtaba Akhtari
Preclinical animal studies have demonstrated an association between maternal use of tyrosine kinase inhibitors and embryofetal toxicity; yet, multiple clinical case series have reported normal pregnancy outcomes and healthy infants in women on these medications during the course of their pregnancy. We describe a case of a woman with chronic myeloid leukemia who had taken the second-generation tyrosine kinase inhibitor dasatinib during the first 12 weeks of her dichorionic diamniotic twin pregnancy and subsequently delivered two low-birth weight infants, one with severe cardiac malformations and the other without apparent birth abnormalities...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29198847/first-delivery-in-a-leukemia-survivor-after-transplantation-of-cryopreserved-ovarian-tissue-evaluated-for-leukemia-cells-contamination
#5
Moran Shapira, Hila Raanani, Iris Barshack, Ninette Amariglio, Sanaz Derech-Haim, Meital Nagar Marciano, Eyal Schiff, Raoul Orvieto, Dror Meirow
OBJECTIVE: To describe a successful autologous ovarian tissue re-transplantation in a sterile leukemia survivor after evaluation for minimal residual disease and provide a review of the current literature. DESIGN: Presentation of a carefully designed workup taken to evaluate tissue for minimal residual disease, its limitations, and applicability to other patients. To date, there have not been any publications of auto-transplantations in leukemia survivors, owing to an estimated high risk for malignancy induction...
November 29, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29186366/human-endometrial-stromal-cell-decidualization-requires-transcriptional-reprogramming-by-plzf
#6
Maria M Szwarc, Lan Hai, William E Gibbons, Mary C Peavey, Lisa D White, Qianxing Mo, David M Lonard, Ramakrishna Kommagani, Rainer B Lanz, Francesco J DeMayo, John P Lydon
Infertility and early embryo-miscarriage is linked to inadequate endometrial decidualization. Although transcriptional reprogramming is known to drive decidualization in response to progesterone, the key signaling effectors that directly mediate this hormone response are not fully known. This knowledge-gap is clinically significant because identifying the early signals that directly mediate progesterone-driven decidualization will address some of the current limitations in diagnosing and therapeutically treating patients at most risk for early pregnancy loss...
November 25, 2017: Biology of Reproduction
https://www.readbyqxmd.com/read/29160610/do-pregnancy-characteristics-contribute-to-rising-childhood-cancer-incidence-rates-in-the-united-states
#7
Rebecca D Kehm, Theresa L Osypuk, Jenny N Poynter, David M Vock, Logan G Spector
BACKGROUND: Since 1975, childhood cancer incidence rates have gradually increased in the United States; however, few studies have conducted analyses across time to unpack this temporal rise. The aim of this study was to test the hypothesis that increasing cancer incidence rates are due to secular trends in pregnancy characteristics that are established risk factors for childhood cancer incidence including older maternal age, higher birthweight, and lower birth order. We also considered temporal trends in sociodemographic characteristics including race/ethnicity and poverty...
November 21, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29110117/successful-treatment-of-acute-promyelocytic-leukemia-in-pregnancy-with-single-agent-all-trans-retinoic-acid
#8
REVIEW
Cordula M Nellessen, Viktor Janzen, Karin Mayer, Giulia Giovannini, Ulrich Gembruch, Peter Brossart, Waltraut M Merz
PURPOSE: The diagnosis of acute promyelocytic leukemia (APL) in pregnancy is an uncommon, life-threatening emergency. Choice of treatment and management of complications are challenging. METHODS: We report the case of a patient with diagnosis of APL at gestational age (GA) 24 + 4. We describe the interdisciplinary management during pregnancy and delivery and provide a 2-year follow-up. Existing reports on APL in pregnancy are summarized. RESULTS: Single-agent induction therapy with all-trans retinoic acid (ATRA) was started and resulted in normalization of blood cell counts after 32 days...
November 6, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29109095/the-association-of-flap-endonuclease-1-genotypes-with-the-susceptibility-of-endometriosis
#9
REVIEW
An-Kuo Chou, Ming-Yi Shen, Fang-Yu Chen, Chieh-Lun Hsiao, Liang-Chun Shih, Wen-Shin Chang, Chia-Wen Tsai, Tsung-Ho Ying, Ming-Hsien Wu, Chung-Yu Huang, DA-Tian Bau
BACKGROUND/AIM: Flap endonuclease 1 (FEN1), a protein with multiple functions in genome stability maintenance, is important in cancer prevention. The two functional germline variants of FEN1, rs174538 and rs4246215, regarding cancer susceptibility have been reported in lung, breast, liver, esophageal, gastric, colorectal cancer, glioma and leukemia, but not endometriosis. In this study, we firstly aimed at evaluating the contribution of FEN1 genotypes to endometriosis risk in a representative Taiwan population...
November 2017: Cancer Genomics & Proteomics
https://www.readbyqxmd.com/read/29079600/treatment-of-essential-thrombocythemia-in-europe-a-prospective-long-term-observational-study-of-3649-high-risk-patients-in-the-exels-study
#10
Gunnar Birgegard, Carlos Besses, Martin Griesshammer, Luigi Gugliotta, Claire N Harrison, Mohamed Hamdani, Jackie Wu, Henri Achenbach, Jean-Jacques Kiladjian
Evaluation of Xagrid® Efficacy and Long-term Safety, a Phase IV, prospective, non interventional study performed in 13 European countries enrolled high risk essential thrombocythemia patients treated with cytoreductive therapy. Primary objectives were safety and pregnancy outcomes. Of 3721 registered patients, 3649 received cytoreductive therapy. At registration, 3611 were receiving: anagrelide (Xagrid®) (n=804), other cytoreductive therapy (n=2666), anagrelide + other cytoreductive therapy (n=141). Median age was 56 vs 70 years for anagrelide vs other cytoreductive therapy...
October 27, 2017: Haematologica
https://www.readbyqxmd.com/read/29075543/undetected-severe-fetal-myelosuppression-following-administration-of-high-dose-cytarabine-for-acute-myeloid-leukemia-is-more-frequent-surveillance-necessary
#11
Jessica Parrott, Marium Holland
BACKGROUND: Cytarabine use during pregnancy carries a 5-7% risk of neonatal cytopenia. We report two cases of fetal myelosuppression following high-dose cytarabine administration for acute myeloid leukemia (AML). CASE 1: A 36-year-old G9P6 diagnosed with AML at 21 weeks was monitored for fetal anemia weekly and growth monthly. At 33 weeks (after 2 cycles), BPP was 2/10 and MCA PSV was elevated at 1.51 MoM. Urgent cesarean section was performed. The infant had an initial pH of 6...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29063331/role-of-lif-cytokine-and-cd34-angiogenesis-marker-in-non-developing-pregnancy
#12
E S Popravka, A S Dyatlova, N S Lin'kova, Yu S Krylova, V O Polyakova, I M Kvetnoi
The expression of cytokine LIF (leukemia inhibiting factor) in the endometrium of women of young reproductive age with non-developing pregnancy of unknown genesis is higher than in older women and women with infection-related miscarriages by 1.26 and 1.43 times, respectively. The expression of angiogenesis marker CD34 in the endometrium of young women with non-developing pregnancy of unknown origin is 1.59 times higher and in case of endometrial inflammation 1.31 times higher than in women of the older reproductive age with the same disease...
October 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29043003/tiaogeng-yijing-decoction-improves-the-pregnancy-outcomes-of-patients-with-poor-ovarian-response-undergoing-in-vitro-fertilization-embryo-transfer
#13
Hui Xue, Juan Dong, Huijun Xu, Xin Huang, Huangguan Dai, Cuifang Hao
The present study aimed to explore the therapeutic effects of the Tiaogeng Yijing decoction on patients with poor ovarian response (POR) undergoing in vitro fertilization-embryo transfer (IVF-ET), in addition to the underlying molecular mechanisms of these effects. A total of 40 patients were randomly and equally assigned to the treatment or control group. Patients in the treatment group received the Tiaogeng Yijing decoction continuously for three menstrual cycles in addition to microstimulation, while patients in the control group underwent microstimulation only...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29036606/socioeconomic-status-and-childhood-cancer-incidence-a-population-based-multilevel-analysis
#14
Rebecca D Kehm, Logan G Spector, Jenny N Poynter, David M Vock, Theresa L Osypuk
The etiology of childhood cancers remains largely unknown, especially regarding environmental and behavioral risk factors. Unpacking the association between socioeconomic status (SES) and incidence may offer insight into such etiology. We tested associations between SES and childhood cancer incidence in a population-based case-cohort study (source cohort: Minnesota birth registry, 1989-2014). Cases, 0-14 years, were linked from the Minnesota Cancer Surveillance System to birth records through probabilistic record linkage...
September 27, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28914556/acute-lymphoblastic-leukemia-during-the-third-trimester-of-pregnancy
#15
Anniek Vlijm-Kievit, Nori G E Jorna, Etelka Moll, Eva Pajkrt, Steven T Pals, Saskia Middeldorp, Bart J Biemond, Sacha S Zeerleder, Marieke A Tio, E Marleen Kemper, Mette D Hazenberg
No abstract text is available yet for this article.
September 15, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28889801/do-health-professionals-have-a-prototype-concept-of-disease-the-answer-is-no
#16
Bjørn Hofmann
BACKGROUND: Health and disease are core concepts in health care and have attracted substantial interest and controversy. In recent and interesting contributions to the debate it has been argued that the challenges with the concept of disease can be resolved by a prototype concept of disease. As a robin is a more prototypical of a bird than a penguin, some diseases are more prototypical than others. If disease is a prototype concept, it would change nosology, but also health care and the study of health and disease...
September 11, 2017: Philosophy, Ethics, and Humanities in Medicine: PEHM
https://www.readbyqxmd.com/read/28845335/congenital-syphilis-masquerading-as-leukemia
#17
Tiffany Lee, Stephanie Bell, Jason Scimeme, Nizar Maraqa
As of late, the incidence of congenital syphilis in the United States is increasing. Each new case represents a failure of preventing, diagnosing, and treating syphilis in pregnant women. Pediatricians should confirm that all women have received adequate screening for and management of syphilis during pregnancy. Congenital syphilis is easily treatable but may be a diagnostic challenge with high morbidity and mortality.
July 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28840048/recurrence-of-chronic-myeloid-leukemia-during-pregnancy-subsequently-achieving-complete-medical-remission
#18
Sasha Mikhael, Ashlee Pascoe, Joseph Prezzato
The treatment of chronic myeloid leukemia (CML) with tyrosine kinase inhibitors (TKIs) in reproductive-aged women poses major dilemmas concerning its associated teratogenicity as observed in many animal studies. Much controversy exists regarding continuation versus discontinuation of its use in pregnancy with some studies suggesting safety of TKIs before and during pregnancy and others reporting toxicity and adverse outcomes. TKIs have become a well-established treatment option for CML, significantly improving prognosis, and yet have been reported to be fetotoxic...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28836277/the-risk-of-preterm-birth-and-growth-restriction-in-pregnancy-after-cancer
#19
Kathleen P Hartnett, Kevin C Ward, Michael R Kramer, Timothy L Lash, Ann C Mertens, Jessica B Spencer, Amy Fothergill, Penelope P Howards
It is unclear whether cancer and its treatments increase the risk of adverse pregnancy outcomes. Our aim was to examine whether cancer survivors have higher risks of poor outcomes in pregnancies conceived after diagnosis than women without cancer, and whether these risks differ by cancer type and race. Diagnoses from cancer registries were linked to pregnancy outcomes from birth certificates in three U.S. states. Analyses were limited to the first, live singleton birth conceived after diagnosis. Births to women without a previous cancer diagnosis in the registry were matched to cancer survivors on age at delivery, parity, race/ethnicity and education...
December 1, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28830391/colony-stimulating-factor-1-and-leukemia-inhibitor-factor-expression-from-current-cycle-cannula-isolated-endometrial-cells-are-associated-with-increased-endometrial-receptivity-and-pregnancy
#20
Felipe Camargo-Díaz, Valeria García, Azucena Ocampo-Bárcenas, Humberto González-Marquez, Esther López-Bayghen
BACKGROUND: Poor endometrial quality is associated with more than a third of embryo implantation failures. Current ultrasonography technology lacks the capacity to determine efficiently the endometrial receptivity during ongoing cycle transfers. We analyzed the relationship between the gene expression profile associated with implantation and clinical pregnancy from endometrial cells taken during embryo transfer. METHODS: Seventy-six patients submitted to a standard ovarian stimulation protocol, in vitro fertilization, and good quality embryos were collected (morphological assessment)...
August 22, 2017: BMC Women's Health
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