Background Pegylated Interferon-alpha-2b (pegIFNα2b) is an effective agent for the treatment of haematological malignancies. As it does not inhibit DNA synthesis, this agent may be safe for use during pregnancy.
Purpose To describe 2 cases of successful pregnancies in patients with haematological disorders treated with pegIFNα2b.
Material and methods Medical record review and literature search.
Results Patient 1: 30-year-old woman diagnosed with polycythaemia vera at age 13, well-controlled with hydroxyurea. Chemotherapy was interrupted due to the patient’s desire for a second pregnancy and treatment with pegIFNα2b 50mcg/week subcutaneously was initiated. (During the first pregnancy she received non-pegylated-IFNα2b with good progression but low tolerance due to influenza-like symptoms). 5 months later, she became pregnant, but was hospitalised due to headaches which caused a dose reduction to 30 mcg/week of pegIFNα2b. Finally, the patient delivered a healthy male infant. 15 days later, pegIFNα2b treatment was interrupted to recommence the usual treatment with hydroxyurea.
Patient 2: 27-year-old woman with Philadelphia chromosome-positive chronic myeloid leukaemia diagnosed at age 22, well-controlled with imatinib. The patient interrupted antineoplastic treatment due to her desire to conceive a child and subcutaneous treatment with pegIFNα2b at 50 mcg/week was initiated. She became pregnant after 4 months and pegIFNα2b dose was increased to 80 mcg/week and developed hypothyroidism which was treated with levothyroxine. Finally, the patient delivered a healthy male infant and 1 month later, she discontinued pegIFNα2b and levothyroxine treatment to recommence her usual treatment with imatinib.
Both were normal full-term deliveries. Infant growth and development have been normal to date (follow-up time of 2 and 3 years). Blood tests were normal during pregnancies. Only mild anaemia and slight neutrophilia were detected in the first patient, but did not require treatment interruption.
Conclusion PegIFNα2b was well tolerated, safe and effective, and caused no complications during the pregnancies. Since chemotherapy agents involve teratogenic effects, pegIFNα2b might be a safe treatment option during pregnancy, although further teratogenic studies are necessary.
References and/or acknowledgements No conflict of interest.
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