内容紹介
A Female Chronic Myeloid Leukemia Patient Who Gave Birth after Stopping Imatinib Intentionally but Who Maintained a Major Molecular Response with Interferon
Summary
Imatinib was administrated to a 38-year-old woman with chronic myeloid leukemia(CML). A major molecular response(MMR)(≤5 copies/0.5 μgRNA in Amp-CML detected using the transcription mediated amplification/hybridization protection assay(TMA/HPA)method)was achieved in 18 months. She maintained MMR for 10 months, and wished to become pregnant. Imatinib was stopped intentionally because she wished to plan a pregnancy, but we prescribed interferon alpha(IFN-α)due to the likelihood of the CML recurring after pregnancy. The nausea caused by IFN-α was improved by administrating it during the night, and she gave birth to a healthy baby by a normal delivery, whilst maintaining MMR. In this case, IFN-α treatment gave good clinical results, the patient's prognosis was improved, and she could maintain a good quality of life. We consider this to be an informative example of IFN-α therapy for CML during pregnancy.
要旨
慢性骨髄性白血病(CML)の38歳女性患者は,イマチニブ投与18か月でtranscription mediated amplification/hybridization protection assay(TMA/HPA)法によるMajor bcr-abl mRNA定量(Amp-CML)において5コピー/0.5 μgRNA未満のmajor molecular response(MMR)となった。妊娠を希望したため,MMRを10か月維持した時点で計画的にイマチニブを中止した。妊娠後のCML再燃傾向に対してインターフェロンアルファを投与し,それに伴う嘔気は夜間投与への変更で改善がみられた。その後,MMRを維持しながら正常分娩で健常児を出産した。今回,治療成績の向上および生命予後の改善に加え,患者の生活の質の確保ができたことで意義のある1例と考え報告した。
目次
Summary
Imatinib was administrated to a 38-year-old woman with chronic myeloid leukemia(CML). A major molecular response(MMR)(≤5 copies/0.5 μgRNA in Amp-CML detected using the transcription mediated amplification/hybridization protection assay(TMA/HPA)method)was achieved in 18 months. She maintained MMR for 10 months, and wished to become pregnant. Imatinib was stopped intentionally because she wished to plan a pregnancy, but we prescribed interferon alpha(IFN-α)due to the likelihood of the CML recurring after pregnancy. The nausea caused by IFN-α was improved by administrating it during the night, and she gave birth to a healthy baby by a normal delivery, whilst maintaining MMR. In this case, IFN-α treatment gave good clinical results, the patient's prognosis was improved, and she could maintain a good quality of life. We consider this to be an informative example of IFN-α therapy for CML during pregnancy.
要旨
慢性骨髄性白血病(CML)の38歳女性患者は,イマチニブ投与18か月でtranscription mediated amplification/hybridization protection assay(TMA/HPA)法によるMajor bcr-abl mRNA定量(Amp-CML)において5コピー/0.5 μgRNA未満のmajor molecular response(MMR)となった。妊娠を希望したため,MMRを10か月維持した時点で計画的にイマチニブを中止した。妊娠後のCML再燃傾向に対してインターフェロンアルファを投与し,それに伴う嘔気は夜間投与への変更で改善がみられた。その後,MMRを維持しながら正常分娩で健常児を出産した。今回,治療成績の向上および生命予後の改善に加え,患者の生活の質の確保ができたことで意義のある1例と考え報告した。