Successful management of pregnancy and hepatic toxicity in a CML female patient treated with nilotinib : a case report and a review

We report a case of a young patient with HBV hepatopathy, diagnosed with CML in March 2006 and treated with imatinib 400mg/die as first line therapy with concomitant Lamivudine. Patient obtained a complete hematologic response (CHR) in 2 months, complete cytogenetic response (CCyR) in six months and...

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Main Authors: Domenico Santorsola, Elisabetta Abruzzese
Format: Article
Language:English
Published: PAGEPress Publications 2015-02-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:http://www.mjhid.org/index.php/mjhid/article/view/2112
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author Domenico Santorsola
Elisabetta Abruzzese
author_facet Domenico Santorsola
Elisabetta Abruzzese
author_sort Domenico Santorsola
collection DOAJ
description We report a case of a young patient with HBV hepatopathy, diagnosed with CML in March 2006 and treated with imatinib 400mg/die as first line therapy with concomitant Lamivudine. Patient obtained a complete hematologic response (CHR) in 2 months, complete cytogenetic response (CCyR) in six months and major molecular response (MMR) at 24 months.  After three years of treatment she became imatinib intolerant and resistant.  In November 2009 patient started nilotinib 400mg/BID. Patient tolerated well the new molecule never experiencing hepatic impairment.  After switching to nilotinib she reached in 12 months transcript reduction more than 3 log (MMR).  Even if patient had been informed of the need of continuous therapy and to use effective methods of contraception during TKI treatment, in 2012 she decided to plan a pregnancy.  In August 2012 a MR4 was documented and treatment discontinued before starting pregnancy. She was observed throughout her pregnancy. The disease remained stable achieving an undetectable transcript level; she delivered a healthy boy in September 2013. Treatment with nilotinib was re-started three months after delivery and she is still in molecular remission (MR5). A complete discussion of the case and the available literature will be presented.
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spelling doaj-art-ecd41224f7dd4fcea7e448cddef7bbeb2025-01-02T01:42:23ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062015-02-0171e2015020e201502010.4084/mjhid.2015.0201543Successful management of pregnancy and hepatic toxicity in a CML female patient treated with nilotinib : a case report and a reviewDomenico Santorsola0Elisabetta Abruzzese1Servizio Dipartimentale di Ematologia e Oncologia. San Nicola Pellegrino, TraniHematology, S. Eugenio Hospital, Tor Vergata University Piazzale dell’Umanesimo 10 00144 Rome, ItalyWe report a case of a young patient with HBV hepatopathy, diagnosed with CML in March 2006 and treated with imatinib 400mg/die as first line therapy with concomitant Lamivudine. Patient obtained a complete hematologic response (CHR) in 2 months, complete cytogenetic response (CCyR) in six months and major molecular response (MMR) at 24 months.  After three years of treatment she became imatinib intolerant and resistant.  In November 2009 patient started nilotinib 400mg/BID. Patient tolerated well the new molecule never experiencing hepatic impairment.  After switching to nilotinib she reached in 12 months transcript reduction more than 3 log (MMR).  Even if patient had been informed of the need of continuous therapy and to use effective methods of contraception during TKI treatment, in 2012 she decided to plan a pregnancy.  In August 2012 a MR4 was documented and treatment discontinued before starting pregnancy. She was observed throughout her pregnancy. The disease remained stable achieving an undetectable transcript level; she delivered a healthy boy in September 2013. Treatment with nilotinib was re-started three months after delivery and she is still in molecular remission (MR5). A complete discussion of the case and the available literature will be presented.http://www.mjhid.org/index.php/mjhid/article/view/2112nilotinib, discontinuation, chronic myeloid leukemia, imatinib, pregnancy, hepatopathy.
spellingShingle Domenico Santorsola
Elisabetta Abruzzese
Successful management of pregnancy and hepatic toxicity in a CML female patient treated with nilotinib : a case report and a review
Mediterranean Journal of Hematology and Infectious Diseases
nilotinib, discontinuation, chronic myeloid leukemia, imatinib, pregnancy, hepatopathy.
title Successful management of pregnancy and hepatic toxicity in a CML female patient treated with nilotinib : a case report and a review
title_full Successful management of pregnancy and hepatic toxicity in a CML female patient treated with nilotinib : a case report and a review
title_fullStr Successful management of pregnancy and hepatic toxicity in a CML female patient treated with nilotinib : a case report and a review
title_full_unstemmed Successful management of pregnancy and hepatic toxicity in a CML female patient treated with nilotinib : a case report and a review
title_short Successful management of pregnancy and hepatic toxicity in a CML female patient treated with nilotinib : a case report and a review
title_sort successful management of pregnancy and hepatic toxicity in a cml female patient treated with nilotinib a case report and a review
topic nilotinib, discontinuation, chronic myeloid leukemia, imatinib, pregnancy, hepatopathy.
url http://www.mjhid.org/index.php/mjhid/article/view/2112
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