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Semin Thromb Hemost 2006; 32(4): 422-429
DOI: 10.1055/s-2006-942763
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Essential Thrombocythemia/Polycythemia Vera and Pregnancy: The Need for an Observational Study in Europe

Martin Griesshammer1 , Sabine Struve2 , Claire M. Harrison2
  • 1Department of Medicine III, Medizinische Universitätsklinik, Ulm, Germany
  • 2Department of Haematology, Guy's and St. Thomas' Foundation Trust, St. Thomas' Hospital, London, United Kingdom
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Publication History

Publication Date:
29 June 2006 (online)

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ABSTRACT

The management of pregnant patients with essential thrombocythemia (ET) and polycythemia vera (PV) may be problematic. In the literature there are ~300 cases of pregnancies reported in ET and less than 50 pregnancies reported in PV. To reduce the effect of reporting bias, we selected articles with either > 10 pregnancies or at least six patients, and here report on the outcome of 195 pregnancies in ET and 36 pregnancies in PV patients. The live birth rate was ~60% in ET and 58% in PV. Spontaneous abortion during the first trimester was the most frequent fetal complication, occurring in 31% of ET pregnancies and in 22% of PV pregnancies, respectively. Major maternal complications were more frequent in PV compared with ET (44.4 versus 7.7%). Treatment with low-dose aspirin during pregnancy in ET seemed to reduce complications and also seemed beneficial during pregnancy in PV. In high-risk pregnancies, the additional use of low molecular weight heparin and/or interferon α should be considered. This article also describes a registry for an observational study concerning pregnancy in chronic Philadelphia chromosome-negative myeloproliferative disorders within the European LeukemiaNet. A potential management algorithm for pregnancies in ET or PV is also provided.

KEYWORDS

Essential thrombocythemia - polycythemia vera - pregnancy - observational study - European LeukemiaNet

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 Professor
M GriesshammerM.D. Ph.D. 

Department of Medicine III, Medizinische Universitätsklinik

Robert-Koch-Strasse 8, D-89081 Ulm, Germany

Email: martin.griesshammer@medizin.uni-ulm.de