Management of Chronic Myeloid Leukemia During Pregnancy: Review of Evidence and Treatment Algorithm. (PubMed, Clin Lymphoma Myeloma Leuk)
Similar to imatinib, nilotinib has limited placental transfer with no congenital malformations reported to date in women who received it later in pregnancy. Dasatinib, however, is contraindicated due to its high association with congenital abnormalities and hydrops fetalis. Ponatinib exposure has been linked to a higher incidence of Hirschsprung's disease and should be avoided in pregnancy. Although no congenital malformations have been reported with bosutinib or asciminib, data remains limited, and their use is not recommended...Hydroxyurea, while not teratogenic, may increase the risk of miscarriage and low birth weight...Shared decision-making and thorough counseling on the risks and benefits of different treatment options are essential. This review examines the potential fetotoxicity of CML therapies, focusing on TKIs and alternative treatments for pregnant women.