Breastfeeding in patients with chronic myeloid leukaemia: case series with measurements of drug concentrations in maternal milk and review of literature

Breastfeeding in patients with chronic myeloid leukaemia (CML) who take tyrosine kinase inhibitors (TKIs) is not recommended but interruption of TKI treatment may cause the loss of remission. We observed the kinetics of the leukaemic clone in 3 women with CML in accordance with treatment interruptio...

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Main Authors: Ekaterina Chelysheva, Sergey Aleshin, Evgenia Polushkina, Roman Shmakov, Igor Shokhin, Ghermes Chilov, Anna Turkina
Format: Article
Language:English
Published: PAGEPress Publications 2018-05-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:https://www.mjhid.org/index.php/mjhid/article/view/3331
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author Ekaterina Chelysheva
Sergey Aleshin
Evgenia Polushkina
Roman Shmakov
Igor Shokhin
Ghermes Chilov
Anna Turkina
author_facet Ekaterina Chelysheva
Sergey Aleshin
Evgenia Polushkina
Roman Shmakov
Igor Shokhin
Ghermes Chilov
Anna Turkina
author_sort Ekaterina Chelysheva
collection DOAJ
description Breastfeeding in patients with chronic myeloid leukaemia (CML) who take tyrosine kinase inhibitors (TKIs) is not recommended but interruption of TKI treatment may cause the loss of remission. We observed the kinetics of the leukaemic clone in 3 women with CML in accordance with treatment interruptions for pregnancy and breastfeeding. The concentrations of nilotinib and imatinib in maternal milk were measured when the breastfeeding period was over. Nilotinib transfer into human breast milk was demonstrated for the first time and had a maximum concentration (Cmax) 129 ng/ml after 4 hours of the drug intake at a dose of 400 mg. The Cmax of imatinib in maternal milk ranged from 420 to 1411 ng/ml after 4-8 hours of the drug intake at a dose of 400-600 mg. Breastfeeding without TKI treatment may be safe with molecular monitoring, but preferably in those patients with CML who have durable deep molecular response.
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publisher PAGEPress Publications
record_format Article
series Mediterranean Journal of Hematology and Infectious Diseases
spelling doaj-art-3a1a8666e2af4988bf60adae9bab80b42025-08-20T02:58:04ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062018-05-01101e2018027e201802710.4084/mjhid.2018.0271754Breastfeeding in patients with chronic myeloid leukaemia: case series with measurements of drug concentrations in maternal milk and review of literatureEkaterina Chelysheva0Sergey Aleshin1Evgenia Polushkina2Roman Shmakov3Igor Shokhin4Ghermes Chilov5Anna Turkina6National Research Center for HematologyCenter of Pharmaceutical Analytics LtdFSBI National Research Center of Obstetrics, Gynecology and Perinatology of the Healthcare Ministry named after V.I. KulakovFSBI National Research Center of Obstetrics, Gynecology and Perinatology of the Healthcare Ministry named after V.I. KulakovCenter of Pharmaceutical Analytics LtdFSBI N.D. Zelinsky Institute of Organic Chemistry of Russian Academy of SciencesNational Research Center for HematologyBreastfeeding in patients with chronic myeloid leukaemia (CML) who take tyrosine kinase inhibitors (TKIs) is not recommended but interruption of TKI treatment may cause the loss of remission. We observed the kinetics of the leukaemic clone in 3 women with CML in accordance with treatment interruptions for pregnancy and breastfeeding. The concentrations of nilotinib and imatinib in maternal milk were measured when the breastfeeding period was over. Nilotinib transfer into human breast milk was demonstrated for the first time and had a maximum concentration (Cmax) 129 ng/ml after 4 hours of the drug intake at a dose of 400 mg. The Cmax of imatinib in maternal milk ranged from 420 to 1411 ng/ml after 4-8 hours of the drug intake at a dose of 400-600 mg. Breastfeeding without TKI treatment may be safe with molecular monitoring, but preferably in those patients with CML who have durable deep molecular response.https://www.mjhid.org/index.php/mjhid/article/view/3331chronic myeloid leukaemia, pregnancy, breastfeeding, milk, breast milk, imatinib, nilotinib, dasatinib, molecular response
spellingShingle Ekaterina Chelysheva
Sergey Aleshin
Evgenia Polushkina
Roman Shmakov
Igor Shokhin
Ghermes Chilov
Anna Turkina
Breastfeeding in patients with chronic myeloid leukaemia: case series with measurements of drug concentrations in maternal milk and review of literature
Mediterranean Journal of Hematology and Infectious Diseases
chronic myeloid leukaemia, pregnancy, breastfeeding, milk, breast milk, imatinib, nilotinib, dasatinib, molecular response
title Breastfeeding in patients with chronic myeloid leukaemia: case series with measurements of drug concentrations in maternal milk and review of literature
title_full Breastfeeding in patients with chronic myeloid leukaemia: case series with measurements of drug concentrations in maternal milk and review of literature
title_fullStr Breastfeeding in patients with chronic myeloid leukaemia: case series with measurements of drug concentrations in maternal milk and review of literature
title_full_unstemmed Breastfeeding in patients with chronic myeloid leukaemia: case series with measurements of drug concentrations in maternal milk and review of literature
title_short Breastfeeding in patients with chronic myeloid leukaemia: case series with measurements of drug concentrations in maternal milk and review of literature
title_sort breastfeeding in patients with chronic myeloid leukaemia case series with measurements of drug concentrations in maternal milk and review of literature
topic chronic myeloid leukaemia, pregnancy, breastfeeding, milk, breast milk, imatinib, nilotinib, dasatinib, molecular response
url https://www.mjhid.org/index.php/mjhid/article/view/3331
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