What we know about HU and pregnancy:
-it was carcinogenic, mutagenic, and teratogenic in animals
-It can cause fetal malformations (partially ossified cranial bones, absence of eye sockets, hydrocephaly, bipartite sternebrae, missing lumbar vertebrae) in animals
-but there are some reports with healthy liveburn (full-term or prematur) - several monthes-years FU - healthy babies, no problems. No major malformations. Hydroxyurea does not cause teratogenic changes in human?
1.J Natl Med Assoc. 2009 Oct;101(10):1046-51. Exposure to hydroxyurea and pregnancy outcomes in patients with sickle cell anemia.
Ballas SK1, McCarthy WF, Guo N, DeCastro L, Bellevue R, Barton BA, Waclawiw MA; Multicenter Study of Hydroxyurea in Sickle Cell Anemia.
2.www.nature.com/leu/journal/v15/n8/full/2402168a.html
Beyond HU - interferon alfa may be useful - many reports in myeloproliferative diseases with success deliveries
ORIGINAL CASE:
Hello, I have an urgent case of a 22-year old lady who is 6 weeks pregnant and just confirmed to have chronic myeloid leukaemia in treatable phase. The total leucocyte count stands at 55,0000/ul , platelets 354K and haematocrit 36%. Spleen and liver were not palpable enlarged.
I am tempted to try her on hydroxyurea, based on the following
"Pharmacotherapy. 1999 Dec;19(12):1459-62, Hydroxyurea in two pregnant women with sickle cell anemia.
Byrd DC1, Pitts SR, Alexander CK"
Thank you