Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
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.
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.
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.
Bates SM, Ginsberg JS. Thrombosis in pregnancy. Curr Opin Hematol. 1997;4(5):335–43.
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.
Chow EY, Haley LP, Vickars LM. Essential thrombocythemia in pregnancy: platelet count and pregnancy outcome. Am J Hematol. 1992;41(4):249–51.
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.
Finazzi G. How to manage essential thrombocythemia. Leukemia. 2012;26(5):875–82.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Perez-Encinas M, Bello JL, Perez-Crespo S, De Miguel R, Tome S. Familial myeloproliferative syndrome. Am J Hematol. 1994;46(3):225–9.
Yoshida Y, Katsurada T, Nakabou Y, Kawabata H. Efficacy of interferon-alpha in essential thrombocythemia during pregnancy. Ann Hematol. 2017;96:877–8.
Harrison C. Pregnancy and its management in the Philadelphia negative myeloproliferative diseases. Br J Haematol. 2005;129(3):293–306.
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.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Informed consent
Consent to publish this case report was obtained from each patient.
Conflict of interest
The authors declare that they have no competing interests.
About this article
Cite this article
Sakai, K., Ueda, A., Hasegawa, M. et al. Efficacy and safety of interferon alpha for essential thrombocythemia during pregnancy: two cases and a literature review. Int J Hematol 108, 203–207 (2018). https://doi.org/10.1007/s12185-017-2397-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12185-017-2397-8