综合报道

母亲慢性粒细胞白血病对新生儿的影响

  • 丁晶 ,
  • 肖一涵 ,
  • 薛玉娟 ,
  • 付洁 ,
  • 刘捷 ,
  • 秦炯 ,
  • 曾超美
展开
  • 北京大学人民医院儿科(北京 100044)

收稿日期: 2022-05-31

  网络出版日期: 2022-10-12

基金资助

北京市临床重点专科项目资助(2018)

Clinical analysis of neonates affected by maternal chronic myeloid leukemia

  • Jing DING ,
  • Yihan XIAO ,
  • Yujuan XUE ,
  • Jie FU ,
  • Jie LIU ,
  • Jiong QIN ,
  • Chaomei ZENG
Expand
  • Department of Pediatrics, Peking University People’s Hospital, Beijing 100044, China

Received date: 2022-05-31

  Online published: 2022-10-12

摘要

目的 回顾性分析母亲患慢性粒细胞白血病(CML)对新生儿的影响。方法 对2010年1月至2022年1月北京大学人民医院产科收治的41例患CML孕妇及其分娩的36例新生儿和同期年龄匹配的健康孕妇所分娩的36例新生儿进行对照研究,分析母亲患慢性粒细胞白血病对新生儿的影响。结果 母患CML新生儿存活率为100%。与母体健新生儿相比母患CML新生儿早产(22.2%对5.6%)、低出生体重儿发生率(19.4%对0)及需转诊至新生儿科治疗率(30.6%对5.6%)更高(P均<0.05)。母妊娠期暴露于药物与未暴露于药物新生儿相比,先天畸形(4.8%对6.7%)、早产(23.8%对20%)、小于胎龄儿(14.3%对6.7%)和围生期缺氧(28.6%对13.3%)发生率差异均无统计学意义(P均>0.05)。转入新生儿科住院的11例母患CML新生儿平均住院时长为(9.6±4.5)天,其中1例发生血小板减少,无白细胞减少及贫血者;生化检查ALT升高1例,AST增高2例。结论 患CML母亲选择合适的治疗方案,其绝大部分新生儿预后良好。

本文引用格式

丁晶 , 肖一涵 , 薛玉娟 , 付洁 , 刘捷 , 秦炯 , 曾超美 . 母亲慢性粒细胞白血病对新生儿的影响[J]. 临床儿科杂志, 2022 , 40(10) : 760 -764 . DOI: 10.12372/jcp.2022.22e0782

Abstract

Objective To retrospectively analyze the influence of chronic myeloid leukemia (CML) on neonates. Methods From January 2010 to January 2022, 41 pregnant women with CML and 36 neonates delivered by them in Peking University People's Hospital were enrolled in this study. Thirty-six neonates born by age-matched healthy pregnant women during the same period were used as controls. The effect of chronic myelogenous leukemia on neonates was analyzed. Results The survival rate of neonates with CML mothers was 100%. Compared with neonates with healthy mothers, the incidence of prematurity (22.2% vs 5.6%, P<0.05), low birth weight (19.4% vs 0, P<0.05) and referral to neonatal ward (30.6% vs 5.6%, P<0.05) was higher in the neonates with CML mothers. Neonates whose mothers were exposed to the drug during pregnancy were compared with neonates whose mothers were not exposed, and there were no differences in the incidence of congenital malformation (4.8% vs 6.7%, P>0.05), prematurity (23.8% vs 20%, P>0.05), small for gestational age (14.3% vs 6.7%, P>0.05) and perinatal asphyxia (28.6% vs 13.3%, P>0.05) between the two groups. The average length of hospital stay was (9.6±4.5) days in 11 neonates with CML mothers who were transferred to neonatal ward. One of them suffered from thrombocytopenia, but none suffered from leukopenia or anemia. Biochemical examination showed abnormal elevation of ALT in 1 child and AST in 2 children. Conclusion When mothers with CML receive appropriate treatment, the vast majority of their newborns have a good prognosis.

参考文献

[1] Castillo DR, Park D, Mehta A, et al. Outcomes of the pregnancies with chronic myeloid leukemia in the tyrosine kinase inhibitor era and literature review[J]. Hematol Rep, 2022, 14(1): 45-53.
[2] Tefferi A, Vardiman JW. Classification and diagnosis of myeloproliferative neoplasms: the 2008 World Health Organization criteria and point-of-care diagnostic algorithms[J]. Leukemia, 2008, 22(1): 14-22.
[3] Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia[J]. Blood, 2016, 127(20): 2391-2405.
[4] Szakács Z, Hegyi PJ, Farkas N, et al. Pregnancy outcomes of women whom spouse fathered children after tyrosine kinase inhibitor therapy for chronic myeloid leukemia: a systematic review[J]. PLoS One, 2020, 15(12): e0243045.
[5] Dou X, Qin Y, Huang X, et al. Planned pregnancy in female patients with chronic myeloid leukemia receiving tyrosine kinase inhibitor therapy[J]. Oncologist, 2019, 24(11): e1141-e1147.
[6] Berman E. Pregnancy in patients with chronic myeloid leukemia[J]. J Natl Compr Canc Netw, 2018, 16(5S): 660-662.
[7] Abruzzese E, Mauro M, Apperley J, et al. Tyrosine kinase inhibitors and pregnancy in chronic myeloid leukemia: opinion, evidence, and recommendations[J]. Ther Adv Hematol, 2020, 11: 2040620720966120.
[8] Hehlmann R. The new ELN recommendations for treating CML[J]. J Clin Med, 2020, 9(11): 3671.
[9] Barzilai M, Avivi I, Amit O. Hematological malignancies during pregnancy[J]. Mol Clin Oncol, 2019, 10(1): 3-9.
[10] Rohilla M, Rai R, Yanamandra U, et al. Obstetric complications and management in chronic myeloid leukemia[J]. Indian J Hematol Blood Transfus, 2016, 32(1): 62-66.
[11] Balsat M, Etienne M, Elhamri M, et al. Successful pregnancies in patients with BCR-ABL-positive leukemias treated with interferon-alpha therapy during the tyrosine kinase inhibitors era[J]. Eur J Haematol, 2018, 101(6): 774-780.
[12] Abu-Tineh M, Kassem N, Abdulla MA, et al. Outcome of pregnancy in the era of PEGylated interferon-α2a in females with chronic myeloid leukemia: an experience from Qatar[J]. Case Rep Oncol, 2020, 13(1): 291-294.
[13] Madabhavi I, Sarkar M, Modi M, et al. Pregnancy outcomes in chronic myeloid leukemia: a single center experience[J]. J Glob Oncol, 2019, 5: 1-11.
[14] Bhandari A, Rolen K, Shah BK. Management of chronic myelogenous leukemia in pregnancy[J]. Anticancer Res, 2015, 35(1): 1-11.
[15] Ono T. Which tyrosine kinase inhibitors should be selected as the first-line treatment for chronic myelogenous leukemia in chronic phase?[J]. Cancers (Basel), 2021, 13(20): 5116.
[16] Rambhatla A, Strug MR, De Paredes JG, et al. Fertility considerations in targeted biologic therapy with tyrosine kinase inhibitors: a review[J]. J Assist Reprod Genet, 2021, 38(8): 1897-1908.
[17] Hochhaus A, Baccarani M, Silver RT, et al. European Leukemia Net 2020 recommendations for treating chronic myeloid leukemia[J]. Leukemia, 2020, 34(4): 966-984.
[18] Samal R, Ghose S. Chronic myeloid leukaemia in pregnancy: call for guidelines[J]. J Obstet Gynaecol, 2019, 39(4): 582-583.
文章导航

/