Myelodysplastic syndrome during pregnancy
Keywords:pregnancy, myelodysplastic syndrome, anemia, delivery, complications
The aim. To highlight such a rare pathology as myelodysplastic syndrome in pregnant women, provide recommendations for treatment, management, and delivery in such patients according to modern literature, and share own experience of successful pregnancy and delivery management in two women with this pathology.
Conclusions. Myelodysplastic syndrome is extremely rare in pregnant women, and the disease is associated with an increased risk of complications for both mother and fetus. The issue of planning and management of pregnancy in patients with this disease should be decided jointly by hematologists and obstetrician-gynecologist after a thorough comprehensive examination clarifying the state of bone marrow hematopoiesis. Pregnancy and delivery should be managed in a highly qualified institution with a multidisciplinary approach and the ability to monitor hemogram, dynamic monitoring of the fetus, adequate and timely supply of blood components.
Cazzola M. (2020). Myelodysplastic Syndromes. The New England journal of medicine, 383(14), 1358-1374. https://doi.org/10.1056/NEJMra1904794
Schanz, J., Tüchler, H., Solé, F., Mallo, M., Luño, E., Cervera, J., Granada, I., Hildebrandt, B., Slovak, M. L., Ohyashiki, K., Steidl, C., Fonatsch, C., Pfeilstöcker, M., Nösslinger, T., Valent, P., Giagounidis, A., Aul, C., Lübbert, M., Stauder, R., Krieger, O., … Haase, D. (2012). New comprehensive cytogenetic scoring system for primary myelodysplastic syndromes (MDS) and oligoblastic acute myeloid leukemia after MDS derived from an international database merge. Journal of clinical oncology, 30(8), 820-829. https://doi.org/10.1200/JCO.2011.35.6394
Swerdlow, S. H., Campo, E., Harris, N. L., Jaffe, E. S., Pileri, S. A., Stein, H., & Thiele, J. (Eds.). (2017). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (4th ed). Lyon, France, International Agency for Research in Cancer.
Marín, G. H., Fazio, P., Rubbo, S., Baistrocchi, A., Sager, G., & Gelemur, A. (2002). Prevalencia de anemia del embarazo y análisis de sus factores condicionantes [Prevalence of anaemia in pregnancy and analysis of the underlying factors]. Atencion primaria, 29(3), 158-163. [in Spanish]. https://doi.org/10.1016/s0212-6567(02)70528-3
Yang, Z., Mei-Ying, L., Shan-Mi, W., & Xiao-Hui, Z. (2015). Pregnancy and myelodysplastic syndrome: an analysis of the clinical characteristics, maternal and fetal outcomes. The journal of maternal-fetal & neonatal medicine, 28(18), 2155-2159. https://doi.org/10.3109/14767058.2014.980229
Peng, C., Cui, T., & Yao, Q. (2021). Labor induction in pregnancy complicated by myelodysplastic syndrome: A case report. Clinical case reports, 9(4), 2032-2035. https://doi.org/10.1002/ccr3.3935
Fadilah, S. A., & Roswati, M. N. (1999). Refractory anaemia with excess of blasts in transformation (RAEB-T) during pregnancy with haematological remission following delivery. British journal of haematology, 104(4), 935-936. https://doi.org/10.1046/j.1365-2141.1999.1331h.x
Essien, E. M., Sharma, U., Upadhaya, K., & Malik, R. (1998). Myelodysplastic syndrome and successful pregnancy. International journal of hematology, 68(4), 449-452. https://doi.org/10.1016/s0925-5710(98)00085-1
Al-Ameri, A., Cherry, M., Garcia-Manero, G., & Quintás-Cardama, A. (2011). Standard therapy for patients with myelodysplastic syndromes. Clinical lymphoma, myeloma & leukemia, 11(4), 303-313. https://doi.org/10.1016/j.clml.2011.06.008
NCCN Clinical Practice Guidelines in Oncology. (2012). Myelodysplastic syndromes v 1.2012. http://www.nccn.org/professionals/physician_gls/pdf/mds.pdf
Volpicelli, P., Latagliata, R., Breccia, M., Carmosino, I., Stefanizzi, C., Napoleone, L., Vozella, F., Levi, A., Natalino, F., & Alimena, G. (2008). Pregnancy in patients with myelodysplastic syndromes (MDS). Leukemia research, 32(10), 1605-1607. https://doi.org/10.1016/j.leukres.2008.02.006
Hoeks, M., Kranenburg, F. J., Middelburg, R. A., van Kraaij, M., & Zwaginga, J. J. (2017). Impact of red blood cell transfusion strategies in haemato-oncological patients: a systematic review and meta-analysis. British journal of haematology, 178(1), 137-151. https://doi.org/10.1111/bjh.14641
Greenberg, P. L., Stone, R. M., Al-Kali, A., Barta, S. K., Bejar, R., Bennett, J. M., Carraway, H., De Castro, C. M., Deeg, H. J., DeZern, A. E., Fathi, A. T., Frankfurt, O., Gaensler, K., Garcia-Manero, G., Griffiths, E. A., Head, D., Horsfall, R., Johnson, R. A., Juckett, M., Klimek, V. M., … Smith, C. (2017). Myelodysplastic Syndromes, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network : JNCCN, 15(1), 60-87. https://doi.org/10.6004/jnccn.2017.0007
Steensma, D. P., & Tefferi, A. (2001). Myelodysplastic syndrome and pregnancy: the Mayo Clinic experience. Leukemia & lymphoma, 42(6), 1229-1234. https://doi.org/10.3109/10428190109097747
Hellström-Lindberg E. (1995). Efficacy of erythropoietin in the myelodysplastic syndromes: a meta-analysis of 205 patients from 17 studies. British journal of haematology, 89(1), 67-71. https://doi.org/10.1111/j.1365-2141.1995.tb08909.x
Sackmann Massa, F., & Pavlovsky, S. (2009). Myelodysplastic syndrome and pregnancy: case report. Leukemia research, 33(3), e23-e25. https://doi.org/10.1016/j.leukres.2008.06.035
Park, S., Greenberg, P., Yucel, A., Farmer, C., O'Neill, F., De Oliveira Brandao, C., & Fenaux, P. (2019). Clinical effectiveness and safety of erythropoietin-stimulating agents for the treatment of low- and intermediate-1-risk myelodysplastic syndrome: a systematic literature review. British journal of haematology, 184(2), 134-160. https://doi.org/10.1111/bjh.15707
Platzbecker, U., Symeonidis, A., Oliva, E. N., Goede, J. S., Delforge, M., Mayer, J., Slama, B., Badre, S., Gasal, E., Mehta, B., & Franklin, J. (2017). A phase 3 randomized placebo-controlled trial of darbepoetin alfa in patients with anemia and lower-risk myelodysplastic syndromes. Leukemia, 31(9), 1944-1950. https://doi.org/10.1038/leu.2017.192
Ak, M. A., Sahip, B., Geduk, A., Ucar, M. A., Kale, H., Hacibekiroglu, T., Polat, M. G., Kalpakci, Y., Bolaman, A. Z., Guvenc, B., & Ertop, S. (2022). The Clinical Efficacy of Epoetin Alfa and Darbepoetin Alfa in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Retrospective Multi-center Real-Life Study. Indian journal of hematology & blood transfusion, 38(2), 299-308. https://doi.org/10.1007/s12288-021-01458-1
How to Cite
LicenseAuthors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)