Usually at diagnosis of CML in young ladies,we always start therapy with 2ed generation TKIs and we strongly advise them to wait for becoming pregnant ,only when MR4 has been obtained for at least 3 months. She can then conceive, (preferably assisted pregnancy/ in vitro fertilization of oocytes) and during that time and until delivery, we switch to aIFN 3 MU 3 times weekly sc, with monthly monitor of bcd-abl levels .
2) If the lady with CML is >40-45 yeas old and in chronic phase of the disease, we start IFNa and we urge her to start a program of in vitro fertilization of her oocytes and freezing of fertilized embryos. After that , we switch to 2ed generation TKI and wait for her programmed pregnancy until she has MR4 for minimum 3 months as previously
Panos Panagiotidis