Women with a myeloproliferative neoplasm can have healthy pregnancies, as long as they coordinate their care and know what to look out for.
While most patients with myeloproliferative neoplasms (MPNs) tend to be elderly, there is a group of patients who are of childbearing age and should take special considerations if they are simultaneously facing pregnancy and an MPN diagnosis.
The umbrella of MPN is made up of multiple diagnoses: chronic myelogenous leukemia, polycythemia vera, essential thrombocythemia and primary myelofibrosis. The majority of patients who are under the age of 40 tend to have essential thrombocythemia, explained Dr. Naseema Gangat.
Gangat, a hematologist/oncologist at the Mayo Clinic, recently spoke with CURE® about what pregnant patients with an MPN diagnosis should know.
“My advice to these young women would be that they have to be aware of the heightened risk,” Gangat said. “If they are planning pregnancy at the time when they get diagnosed, they have to be counseled appropriately. They need to be under the care of high-risk obstetrics, manage their cardiovascular risks, which may be outside of the MPN specialists’ realm.”
MPN and Pregnancy Risks to Look Out For
Gangat explained that MPNs, as well as pregnancy, can put individuals at risk for thrombosis (blood clots), which can be extremely dangerous. If a pregnant woman with an MPN experiences any of the following symptoms, Gangat recommends that she reports to the emergency room immediately:
Patients and their clinicians should be thoughtful about the drugs chosen to treat the MPN, too. Hydroxyurea can have harmful side effects, while interferons tend to be preferred, Gangat said. Heparin may be a safer blood thinner choice than warfarin. Baby aspirin has been proven to be safe during pregnancy.
Women should also be monitored for preeclampsia and diabetes, as is the norm for all pregnant individuals. However, when a woman also has an MPN diagnosis, coordinating communication among clinicians is crucial.
Coordinate Care Teams
“We need to put it into perspective because sometimes (patients) are following with their blood doctor, they may not reach obstetric care right away… They do require very careful monitoring for the signs and symptoms (of dangerous side effects),” Gangat said.
There are currently no specialized multidisciplinary care teams to treat these women, but Gangat is hoping that changes soon – or at least that the women get the important information that they need. Through her research, she is hoping to achieve that.
“It would be nice to provide them with the information as well, because obviously there’s a lot of anxiety when you have a chronic blood condition,” Gangat said. “My role has been to create more awareness. And I continue to work on that subject. Hopefully we’ll have more and more data as the years go on and obstetrics care improves, and as hematologic care improves.”
Healthy Pregnancies Are Possible With an MPN Diagnosis
It is very possible for women with an MPN to have full, healthy pregnancies.
“Thankfully, if they’re managed appropriately, the risk for preterm loss and maternal complications is not incredibly high compared to the general population, but I think we need to create more awareness to seek the right care,” Gangat said.
Living with MPN? Join CURE for the next Educated Patient Webinar: Understanding Myeloproliferative Neoplasms (MPNs) and Treatment Options on Thursday, Oct. 28 at 7pm ET. Learn more and register.
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