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Pregnancy while on TKI

  • Takeshi Kondo
  • Takeshi Kondo's Avatar Topic Author
2 days 7 hours ago #2141 by Takeshi Kondo
Replied by Takeshi Kondo on topic Pregnancy while on TKI
I would propose two therapeutic options.
1) If the patient has never been treated with imatinib or nilotinib, I would first switch from dasatinib. This is because dasatinib cannot be used beyond the first trimester of pregnancy, and imatinib or nilotinib may be required in case of molecular relapse during the second or third trimester. After switching, she may attempt conception while continuing TKI therapy; however, careful pregnancy testing is needed, and the TKI should be discontinued by around 4 weeks of gestation to minimize fetal exposure.
2) If MMR has been achieved but DMR has not yet been obtained, maintaining TFR during pregnancy would be quite challenging. Therefore, switching from TKI to interferon-α should be considered. A Japanese survey has reported some cases in which patients maintained MMR after switching to interferon-α and successfully achieved pregnancy and delivery, suggesting that this approach may also be worth attempting in this case.

Given her age of 39 years, it would be advisable to minimize delays in achieving pregnancy, for example by considering the concurrent use of assisted reproductive technology (ART) while on interferon-α.
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