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Advice on use of interferon during pregnancy (any literature out there?)

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Hi all,

I am about to embark on a frozen embryo transfer in February after having frozen 5 embryos prior to starting Dasatinib 3 years ago. I have just reached a log 4.5 reduction for the first time and personally I feel like I’m in a good spot.

My doctor has just given me a treatment plan which includes coming off Dasatinib for 4-6 weeks prior to implantation and then going on interferon as soon as I get pregnant.

My doctor has sought advice from a CML/fertility expert so I think she’s keen to follow his lead, but I was wondering if anyone has any literature I could share with her about other approaches to managing pregnancy and CML?

Also, has anyone been on interfuron or have any experience with it? I’ll be honest, I would rather just take the risk and monitor my BCR / ABL than take interfuron as a preventative measure given the side effects are pretty bad including flu like symptoms and fatigue every day.

They discovered my CML during a random routine test so I’ve never had really high numbers and I’ve responded well to Dasatinib since day 1.

I feel like no one is actually considering my specific risk profile, which I feel is low. I’d prefer not to be on anything whilst pregnant. That said, I don’t want to go against my doctor’s thinking either because how am I to know what’s right, and I of course don’t want to put myself in danger.

Any input and advice would be welcomed!

Hi Loralie,

I would urge you to watch this video from Prof Apperley. She’s about the most experienced doctor in the world when it comes to CML and pregnancy.

https://vimeo.com/778953440

She’s not the biggest fan of interferon, and I believe she tries to avoid it. I think her reasoning might be explained in the above video … but basically it boils down to the fact that interferon can make you feel awful, and anyway takes a very long time to work so the benefit is not as great as some people expect. Also, we have a better understanding of TKIs now and the critical times during the pregnancy they must be avoided rather than an outright blanket-ban on them.

You could also reach out directly to Hammersmith Hospital on this link https://cmlsupport.org.uk/asktheexpert which is where Jane practices.

Sounds to me like you have a good case to do what you want - discontinue your TKI, hopefully become pregnant soon, and monitor closely rather than just blindly take interferon.

David.