Successful Pregnancies in a Nigerian Patient with Chronic Myeloid Leukaemia on Imatinib

Abstract

Background: Imatinib mesylate (IM) has become established as the first-line therapy for all patients with chronic myeloid leukaemia (CML) who have cytogenetic or molecular evidence of BCR/ABL mutation. However, animal studies have suggested some teratogenic potential. Additionally, it has been variously associated with reduced fertility due to hypospermia and oligomenorrhoea. In spite of the latter however, several conceptions have been reported among patients or their partners. Patient and Methods: We report the first case of a CML patient conceiving twice in a 12-month period while on IM therapy. OE, a 34-year-old Nigerian lady with CML, who had been on IM since November 2006, became pregnant in March 2007, stopped IM as soon as pregnancy was confirmed, and was delivered vaginally at term of a healthy baby girl in November 2007. While lactating in February 2008, she became pregnant again, but she opted for elective termination due to a failure to attain complete cytogenetic remission from frequent therapy interruptions. Results and Conclusion: Her baby continues to thrive normally after 16 months of follow-up. This suggests that the drug may not reduce the ability to conceive in some patients.