For pregnant women with essential thrombocythemia (ET), no standard approach for managing the platelet count has been established. We present the cases of two pregnant women with ET treated with interferon (IFN)-alpha. Each case showed a marked platelet decrease, from values within normal limits at the time of delivery, with no severe adverse events. To clarify the efficacy and safely of IFN alpha for ET during pregnancy, we performed a literature review. A total of 43 pregnant women with ET were ultimately identified from 12 articles and the present cases. IFN-alpha therapy decreased platelet counts to normal levels at birth in many cases, and there were no adverse events that required the discontinuation of IFN-alpha treatment. Overall, 93% of pregnant women with ET gave birth to healthy babies. We consider that, given its efficacy and safety, IFN-alpha therapy is a reasonable treatment option for pregnant women with ET.
Essential thrombocythemia Pregnancy Prenatal care Interferon alpha Literature review
This is a preview of subscription content, log in to check access.
Compliance with ethical standards
Consent to publish this case report was obtained from each patient.
Conflict of interest
The authors declare that they have no competing interests.
Barbui T, Thiele J, Passamonti F, Rumi E, Boveri E, Ruggeri M, et al. Survival and disease progression in essential thrombocythemia are significantly influenced by accurate morphologic diagnosis: an international study. J Clin Oncol. 2011;29(23):3179–84.CrossRefPubMedGoogle Scholar
Passamonti F, Randi ML, Rumi E, Pungolino E, Elena C, Pietra D, et al. Increased risk of pregnancy complications in patients with essential thrombocythemia carrying the JAK2 (617V>F) mutation. Blood. 2007;110(2):485–9.CrossRefPubMedGoogle Scholar
Melillo L, Tieghi A, Candoni A, Radaelli F, Ciancia R, Specchia G, et al. Outcome of 122 pregnancies in essential thrombocythemia patients: a report from the Italian registry. Am J Hematol. 2009;84(10):636–40.CrossRefPubMedGoogle Scholar
Asano Y, Okaniwa A. In utero morphological effects of hydroxyurea on the fetal development in Sprague–Dawley rats. Jikken Dobutsu. 1987;36(2):143–9.PubMedGoogle Scholar
Chow EY, Haley LP, Vickars LM. Essential thrombocythemia in pregnancy: platelet count and pregnancy outcome. Am J Hematol. 1992;41(4):249–51.CrossRefPubMedGoogle Scholar
Pagliaro P, Arrigoni L, Muggiasca ML, Poggio M, Russo U, Rossi E. Primary thrombocythemia and pregnancy: treatment and outcome in fifteen cases. Am J Hematol. 1996;53(1):6–10.CrossRefPubMedGoogle Scholar
Cortelazzo S, Finazzi G, Ruggeri M, Vestri O, Galli M, Rodeghiero F, et al. Hydroxyurea for patients with essential thrombocythemia and a high risk of thrombosis. N Engl J Med. 1995;332(17):1132–6.CrossRefPubMedGoogle Scholar
Sobas MA, Perez Encinas MM, Rabunal Martinez MJ, Quinteiro Garcia C, Bello Lopez JL. Anagrelide treatment in early pregnancy in a patient with JAK2V617F-positive essential thrombocythemia: case report and literature review. Acta Haematol. 2009;122(4):221–2.CrossRefPubMedGoogle Scholar
Harrison CN, Bareford D, Butt N, Campbell P, Conneally E, Drummond M, et al. Guideline for investigation and management of adults and children presenting with a thrombocytosis. Br J Haematol. 2010;149(3):352–75.CrossRefPubMedGoogle Scholar
Niittyvuopio R, Juvonen E, Kaaja R, Oksanen K, Hallman H, Timonen T, et al. Pregnancy in essential thrombocythaemia: experience with 40 pregnancies. Eur J Haematol. 2004;73(6):431–6.CrossRefPubMedGoogle Scholar
Martinelli P, Martinelli V, Agangi A, Maruotti GM, Paladini D, Ciancia R, et al. Interferon alfa treatment for pregnant women affected by essential thrombocythemia: case reports and a review. Am J Obstet Gynecol. 2004;191(6):2016–20.CrossRefPubMedGoogle Scholar
Iwashita T, Fujitani M, Yamamoto Y, Katsurada T, Yoshida Y. Interferon-alfa treatment of essential thrombocythemia during pregnancy. Intern Med. 2006;45(20):1161–4.CrossRefPubMedGoogle Scholar
Singh N, Kumar S, Roy KK, Sharma V, Jalak A. Successful maternal and fetal outcome in a rare case of essential thrombocythemia with pregnancy using interferon alpha. Platelets. 2012;23(4):319–21.CrossRefPubMedGoogle Scholar
Williams JM, Schlesinger PE, Gray AG. Successful treatment of essential thrombocythaemia and recurrent abortion with alpha interferon. Br J Haematol. 1994;88(3):647–8.CrossRefPubMedGoogle Scholar
Shpilberg O, Shimon I, Sofer O, Dolitski M, Ben-Bassat I. Transient normal platelet counts and decreased requirement for interferon during pregnancy in essential thrombocythaemia. Br J Haematol. 1996;92(2):491–3.CrossRefPubMedGoogle Scholar
Vianelli N, Gugliotta L, Tura S, Bovicelli L, Rizzo N, Gabrielli A. Interferon-alpha 2a treatment in a pregnant woman with essential thrombocythemia. Blood. 1994;83(3):874–5.PubMedGoogle Scholar
Diez-Martin JL, Banas MH, Fernandez MN. Childbearing age patients with essential thrombocythemia: should they be placed on interferon? Am J Hematol. 1996;52:331–2.CrossRefPubMedGoogle Scholar
Pulik M, Lionnet F, Genet P, Petitdidier C, Jary L. Platelet counts during pregnancy in essential thrombocythaemia treated with recombinant alpha-interferon. Br J Haematol. 1996;93(2):495.PubMedGoogle Scholar
Perez-Encinas M, Bello JL, Perez-Crespo S, De Miguel R, Tome S. Familial myeloproliferative syndrome. Am J Hematol. 1994;46(3):225–9.CrossRefPubMedGoogle Scholar
Yoshida Y, Katsurada T, Nakabou Y, Kawabata H. Efficacy of interferon-alpha in essential thrombocythemia during pregnancy. Ann Hematol. 2017;96:877–8.CrossRefPubMedGoogle Scholar
Harrison C. Pregnancy and its management in the Philadelphia negative myeloproliferative diseases. Br J Haematol. 2005;129(3):293–306.CrossRefPubMedGoogle Scholar
Vantroyen B, Vanstraelen D. Management of essential thrombocythemia during pregnancy with aspirin, interferon alpha-2a and no treatment. A comparative analysis of the literature. Acta Haematol. 2002;107(3):158–69.CrossRefPubMedGoogle Scholar