BCR/ABL阴性骨髓增殖性肿瘤合并妊娠诊治概况

Overview of pregnancy in BCR/ABL negative myeloproliferative neoplasms

骨髓增殖性肿瘤(myeloproliferative neoplasms,MPN)是一种起源于骨髓造血干细胞克隆性疾病,主要包括真性红细胞增多症(polycythemia vera,PV)、原发性血小板增多症(essential thrombocythemia,ET)、原发性骨髓纤维化(primary myelofibrosis,PMF)、慢性中性粒细胞增多症(CNL)、慢性嗜酸性粒细胞白血病.

BCR-ABL negative myeloproliferative neoplasms have been widely known and caught a lot of attention with the application of new molecular diagnostic technology and the full awareness of health in society. There is a rising trend in patients younger than 40 years diagnosed with MPN due to the early diagnosis technique with the generalization of diagnostic criteria and implementation of treatment guideline. With the opening of the second birth policy, the demand for pregnancy in MPN patients is increasing and the associated problems are coming clearer and need to be solved urgently. A lot of questions need to be answered such as Whether MPN patients could have pregnancy? When is the optimal time to be pregnant? What are the major risks they will undertake with pregnancy? Which precautions should be kept in mind? How to adjust MPN treatment during pregnancy and perinatal period? What is the potential impact of MPN on fetus development and breast feeding after delivery? At present, there are few reports of MPN combined with pregnancy and the total number of pregnancies is about 1100 all over the world. The diagnosis and treatment of MPN combined with pregnancy has become an international issue, but there are limited cases reported in China. Therefore, this paper gives a comprehensive overview of pregnancy associated issues in MPN patients.