Pregnancy outcomes in BCR-Abl1-negative MPNs
| Study . | Patients/ pregnancies (n) . | Diagnosis (n) molecular markers (%) . | Treatment during pregnancy (%) . | Maternal complications (%) . | Fetal complications (%) . | Live births (%) . |
|---|---|---|---|---|---|---|
| Landtblom et al4 | 229/342 | ET 158/229 PV 27/229 PMF 24/229 MPN-U 20/229 | NA | Hemorrhage 14 Thrombosis 1 Preeclampsia, HELLP, and gestational HTN 6 | Preterm delivery 12 Stillbirth 0.6 | NA |
| How et al10 | 52/121 | ET 52/52 JAK2 56 CALR 11.5 MPL 0 triple neg 7.7 | ASA 61.2 IFN-α 1.6 LMWH 31.7 (before pregnancy: CRT 10.7) | Hemorrhage 5.8 Thrombosis 2.5 Preeclampsia 3.3 Gestational HTN 0.8 | Miscarriage/ectopic/abortion 32.2 Stillbirth 0.8 Preterm delivery 7.4 IUGR 2.5 | 69 |
| Gangat et al11 | 55/95 | ET 55/55 JAK2 45 CALR 35 Triple neg 12 | ASA 60 LMWH 9 IFN-α 15 Anagrelide 5 HU 2 Radioactive phosphorus 2 | Hemorrhage 7 Thrombosis 4 Preeclampsia 4 Placental abruption 2 | Miscarriage/ectopic/abortion 31 Stillbirth 1 Preterm delivery 2 IUGR 3 | 67 |
| 4/5 | PV 4/4 | ASA 29 ASA+LMWH 29 | Thrombosis 20 | 100 | ||
| 2/2 | PMF 2/2 CALR 100 | ASA 100 | NA | 100 | ||
| Sokołowska and Jawniak12 | 60/104 | ET 47/60 PV 3/60 PMF 10/60 JAK2 56.7 CALR 15 | LMWH 18.3 LMWH + ASA 9.6 ASA 23.1 IFN-α 46.2 Apheresis 1 | NA | Miscarriage/ectopic/abortion 18.3 Stillbirth 5.8 | 72.1 |
| How et al13 | 58/130 | ET 53/58 PV 5/58 JAK2 60.3 CALR 12.1 | ASA 58.5 IFN-α 1.5 LMWH 6.9 | Hemorrhage 6.9 Thrombosis 2.3 | Abortions 24.6 | 70 |
| Lapoirie et al14 | 14/27 | ET 9/14 PV 5/14 | ASA 67 Heparin ± IFN-α 72 | Hemorrhage 11 Thrombosis 15 HELLP 15 | Abortion 22 Stillbirth 4 Preterm delivery 15 IUGR 15 | 70 |
| Bertozzi et al15 | 15/24 | PV 15/15 JAK2 V617F 85.7 JAK2 exon12 14.3 | ASA 67 ASA + LMWH 12 IFN-α 4 | Unspecified 16.7 | Miscarriage/ectopic/abortion 29.2 Stillbirth 8.3 Preterm delivery 20.8 IUGR 4.2 | 62.5 |
| Alimam et al3 | 58/58 | ET 47/58 PV 5/58 PMF 5/58 MPN-U 1/58 JAK2 58.3 | ASA 47 ASA + LMWH 38 LMWH 3 IFN-α 14 | Hemorrhage 13 Preeclampsia 9 | Preterm delivery 15 IUGR 23 | 100 |
| Griesshammer and Schauer16 | 48/121 Only 109 pregnancies analyzed at time of abstract submission | PV 48/48 | IFN-α 11 ASA in most patients with already known MPN diagnosis Venesection as required to target a hematocrit of 40% (mainly required in the first trimester) | Hemorrhage 2.7 Minor bleeding 8.2 Thrombosis 2.7 | Miscarriage/ectopic/abortion 23 Stillbirth 10 | 67 |
| Palandri et al17 | 13/24 | ET 13/13 JAK2 25 | IFN-α alone 4.2 IFN-α + ASA 8.3 ASA 37.5 | Placental abruption 4.2 | Abortion 37.5 | 62.5 |
| Melillo et al18 | 92/122 | ET 92/92 JAK2 51 | ASA 76.2 Additional LMWH in last week of pregnancy + postpartum 15.5 IFN-α 16.4 | Hemorrhage PPH 0.8 Thrombosis 4.1 Preeclampsia 2.5 Placental abruption 0.8 | Abortion 21.3 Stillbirth 3.3 Preterm delivery 9.8 IUGR 1.6 | 75.4 |
| Gangat et al19 | 36/63 | ET 36/36 JAK2 50 | ASA 69 (before pregnancy: CRT 31.7) | Hemorrhage PPH 3 Preeclampsia 3 | Miscarriage/ectopic/abortion 40 | 60 |
| Tulpule et al20 | 2/4 | PMF 2/2 JAK2 and MPL neg 100 | ASA 25 ASA + LMWH 75 | Hemorrhage PPH 25 | Abortion 25 Stillbirth 25 | 50 |
| Passamonti et al21 | 58/96 | ET 58/58 JAK2 49 | ASA 62 IFN-α 3 (before pregnancy: CRT 14) | Preeclampsia 4 HTN 5 | Miscarriage/ectopic/abortion 32.2 Stillbirth 3 IUGR 4 | 64 |
| Robinson et al22 | 8/18 | PV 18/18 | Aspirin 61.1 IFN-α 16.7 LMWH 16.7 Venesection 22.2 | Thrombosis 5.6 Preeclampsia 16.7 Placental abruption 11.1 | Miscarriage/ectopic/abortion 22.2 Stillbirth 16.7 Preterm delivery 16.7 IUGR 16.7 | 61.1 |
| Niittyvuopio et al23 | 16/40 | ET 16/16 | ASA alone 20 ASA + IFN-α 5 (before pregnancy: CRT 21) | Preeclampsia 5 Eclampsia 2.5 | Miscarriage/ectopic/abortion 32.5 Stillbirth 5 Preterm 5 | 57.5 |
| Wright and Tefferi24 | 20/43 | ET 20/20 | ASA 44 LMWH 2 (before pregnancy: CRT 58) | Placental abruption 2 | Miscarriage/ectopic/abortion 44 Stillbirth 5 Preterm 2 | 51 |
| Cincotta et al25 | 12/30 | ET 12/12 | ASA only 23 IFN-α 13 Heparin 3 (before pregnancy: HU 8) | Placental abruption 16.6 | Miscarriage/ectopic/abortion 20 Stillbirth 23.3 | 56.6 |
| Bangerter et al26 | 9/17 | ET 9/9 | ASA alone 6 ASA + LMWH 29 (before pregnancy: HU 11) | Hemorrhage 29 Transient ischemic attack 6 | Miscarriage/ectopic/abortion 35 Preterm 18 | 65 |
| Randi et al27 | 13/16 | ET 13/13 | ASA 43.8 | Thrombosis 18.8 | Miscarriage/ectopic/abortion 9.1 Preterm delivery 9.1 | 81.3 |
| Pagliaro et al28 | 9/15 | ET 9/9 | ASA 20 ASA + heparin 46.7 | Hemorrhage 6.6 Thrombosis 26.6 | Miscarriage/ectopic/abortion 20 Stillbirth 20 Preterm 20 IUGR 13.3 | 60 |
| Beressi et al29 | 18/34 | ET 18/18 | ASA 55.5 | Hemorrhage 50 Thrombosis 33.3 Placental abruption 3 | Miscarriage/ectopic/abortion 44 Stillbirth 3 Preterm 3 | 50 |
| Study . | Patients/ pregnancies (n) . | Diagnosis (n) molecular markers (%) . | Treatment during pregnancy (%) . | Maternal complications (%) . | Fetal complications (%) . | Live births (%) . |
|---|---|---|---|---|---|---|
| Landtblom et al4 | 229/342 | ET 158/229 PV 27/229 PMF 24/229 MPN-U 20/229 | NA | Hemorrhage 14 Thrombosis 1 Preeclampsia, HELLP, and gestational HTN 6 | Preterm delivery 12 Stillbirth 0.6 | NA |
| How et al10 | 52/121 | ET 52/52 JAK2 56 CALR 11.5 MPL 0 triple neg 7.7 | ASA 61.2 IFN-α 1.6 LMWH 31.7 (before pregnancy: CRT 10.7) | Hemorrhage 5.8 Thrombosis 2.5 Preeclampsia 3.3 Gestational HTN 0.8 | Miscarriage/ectopic/abortion 32.2 Stillbirth 0.8 Preterm delivery 7.4 IUGR 2.5 | 69 |
| Gangat et al11 | 55/95 | ET 55/55 JAK2 45 CALR 35 Triple neg 12 | ASA 60 LMWH 9 IFN-α 15 Anagrelide 5 HU 2 Radioactive phosphorus 2 | Hemorrhage 7 Thrombosis 4 Preeclampsia 4 Placental abruption 2 | Miscarriage/ectopic/abortion 31 Stillbirth 1 Preterm delivery 2 IUGR 3 | 67 |
| 4/5 | PV 4/4 | ASA 29 ASA+LMWH 29 | Thrombosis 20 | 100 | ||
| 2/2 | PMF 2/2 CALR 100 | ASA 100 | NA | 100 | ||
| Sokołowska and Jawniak12 | 60/104 | ET 47/60 PV 3/60 PMF 10/60 JAK2 56.7 CALR 15 | LMWH 18.3 LMWH + ASA 9.6 ASA 23.1 IFN-α 46.2 Apheresis 1 | NA | Miscarriage/ectopic/abortion 18.3 Stillbirth 5.8 | 72.1 |
| How et al13 | 58/130 | ET 53/58 PV 5/58 JAK2 60.3 CALR 12.1 | ASA 58.5 IFN-α 1.5 LMWH 6.9 | Hemorrhage 6.9 Thrombosis 2.3 | Abortions 24.6 | 70 |
| Lapoirie et al14 | 14/27 | ET 9/14 PV 5/14 | ASA 67 Heparin ± IFN-α 72 | Hemorrhage 11 Thrombosis 15 HELLP 15 | Abortion 22 Stillbirth 4 Preterm delivery 15 IUGR 15 | 70 |
| Bertozzi et al15 | 15/24 | PV 15/15 JAK2 V617F 85.7 JAK2 exon12 14.3 | ASA 67 ASA + LMWH 12 IFN-α 4 | Unspecified 16.7 | Miscarriage/ectopic/abortion 29.2 Stillbirth 8.3 Preterm delivery 20.8 IUGR 4.2 | 62.5 |
| Alimam et al3 | 58/58 | ET 47/58 PV 5/58 PMF 5/58 MPN-U 1/58 JAK2 58.3 | ASA 47 ASA + LMWH 38 LMWH 3 IFN-α 14 | Hemorrhage 13 Preeclampsia 9 | Preterm delivery 15 IUGR 23 | 100 |
| Griesshammer and Schauer16 | 48/121 Only 109 pregnancies analyzed at time of abstract submission | PV 48/48 | IFN-α 11 ASA in most patients with already known MPN diagnosis Venesection as required to target a hematocrit of 40% (mainly required in the first trimester) | Hemorrhage 2.7 Minor bleeding 8.2 Thrombosis 2.7 | Miscarriage/ectopic/abortion 23 Stillbirth 10 | 67 |
| Palandri et al17 | 13/24 | ET 13/13 JAK2 25 | IFN-α alone 4.2 IFN-α + ASA 8.3 ASA 37.5 | Placental abruption 4.2 | Abortion 37.5 | 62.5 |
| Melillo et al18 | 92/122 | ET 92/92 JAK2 51 | ASA 76.2 Additional LMWH in last week of pregnancy + postpartum 15.5 IFN-α 16.4 | Hemorrhage PPH 0.8 Thrombosis 4.1 Preeclampsia 2.5 Placental abruption 0.8 | Abortion 21.3 Stillbirth 3.3 Preterm delivery 9.8 IUGR 1.6 | 75.4 |
| Gangat et al19 | 36/63 | ET 36/36 JAK2 50 | ASA 69 (before pregnancy: CRT 31.7) | Hemorrhage PPH 3 Preeclampsia 3 | Miscarriage/ectopic/abortion 40 | 60 |
| Tulpule et al20 | 2/4 | PMF 2/2 JAK2 and MPL neg 100 | ASA 25 ASA + LMWH 75 | Hemorrhage PPH 25 | Abortion 25 Stillbirth 25 | 50 |
| Passamonti et al21 | 58/96 | ET 58/58 JAK2 49 | ASA 62 IFN-α 3 (before pregnancy: CRT 14) | Preeclampsia 4 HTN 5 | Miscarriage/ectopic/abortion 32.2 Stillbirth 3 IUGR 4 | 64 |
| Robinson et al22 | 8/18 | PV 18/18 | Aspirin 61.1 IFN-α 16.7 LMWH 16.7 Venesection 22.2 | Thrombosis 5.6 Preeclampsia 16.7 Placental abruption 11.1 | Miscarriage/ectopic/abortion 22.2 Stillbirth 16.7 Preterm delivery 16.7 IUGR 16.7 | 61.1 |
| Niittyvuopio et al23 | 16/40 | ET 16/16 | ASA alone 20 ASA + IFN-α 5 (before pregnancy: CRT 21) | Preeclampsia 5 Eclampsia 2.5 | Miscarriage/ectopic/abortion 32.5 Stillbirth 5 Preterm 5 | 57.5 |
| Wright and Tefferi24 | 20/43 | ET 20/20 | ASA 44 LMWH 2 (before pregnancy: CRT 58) | Placental abruption 2 | Miscarriage/ectopic/abortion 44 Stillbirth 5 Preterm 2 | 51 |
| Cincotta et al25 | 12/30 | ET 12/12 | ASA only 23 IFN-α 13 Heparin 3 (before pregnancy: HU 8) | Placental abruption 16.6 | Miscarriage/ectopic/abortion 20 Stillbirth 23.3 | 56.6 |
| Bangerter et al26 | 9/17 | ET 9/9 | ASA alone 6 ASA + LMWH 29 (before pregnancy: HU 11) | Hemorrhage 29 Transient ischemic attack 6 | Miscarriage/ectopic/abortion 35 Preterm 18 | 65 |
| Randi et al27 | 13/16 | ET 13/13 | ASA 43.8 | Thrombosis 18.8 | Miscarriage/ectopic/abortion 9.1 Preterm delivery 9.1 | 81.3 |
| Pagliaro et al28 | 9/15 | ET 9/9 | ASA 20 ASA + heparin 46.7 | Hemorrhage 6.6 Thrombosis 26.6 | Miscarriage/ectopic/abortion 20 Stillbirth 20 Preterm 20 IUGR 13.3 | 60 |
| Beressi et al29 | 18/34 | ET 18/18 | ASA 55.5 | Hemorrhage 50 Thrombosis 33.3 Placental abruption 3 | Miscarriage/ectopic/abortion 44 Stillbirth 3 Preterm 3 | 50 |
ASA, aspirin; CRT, cytoreductive therapy; HELLP, haemolysis, elevated liver enzymes, low platelets; HTN, hypertension; HU, hydroxyurea; IFN-α, interferon alfa; IUGR, intrauterine growth restriction; MPN-U, myeloproliferative neoplasm, unspecified; NA, not available; PPH, postpartum hemorrhage.