Successful Pregnancies During Crizotinib Therapy for Anaplastic Lymphoma Kinase Positive Lymphoma.

in Hematological oncology by Veronica Guglielmana, Francesco Maria Fusi, Valentina Giardini, Federica Cocito, Carlo Gambacorti-Passerini

TLDR

  • The study presents four cases of successful pregnancies during crizotinib treatment for ALK+ ALCL, demonstrating the potential for conception without compromising disease control.
  • Key Insights: Crizotinib may be safely used during pregnancy planning for patients with ALK+ ALCL, and future studies should investigate optimal management strategies for fertility preservation.

Abstract

Anaplastic lymphoma kinase positive (ALK+) anaplastic large cell lymphoma (ALCL) typically affects young individuals and, despite high responsiveness to cytotoxic drugs, relapses occur in over 50% of patients. Crizotinib has improved outcomes, but its management in patients desiring parenthood remains an issue. This study presents the first description of four successful pregnancies during crizotinib treatment for ALK+ALCL: a female patient achieving two pregnancies through assisted reproductive technologies (ART), temporarily discontinuing crizotinib and maintaining a complete remission (CR), and a male patient conceiving naturally while on continuous therapy. These cases demonstrate crizotinib potential to support conception without compromising disease control, even in the absence of specific guidelines on treatment discontinuation.

Overview

  • A novel study on the first four successful pregnancies during crizotinib treatment for ALK+ anaplastic large cell lymphoma (ALCL).
  • Four patients, two female and two male, underwent successful pregnancies while receiving crizotinib therapy for ALK+ ALCL.
  • The study aims to explore the possibility of conceiving during crizotinib treatment without compromising disease control and without specific guidelines on treatment discontinuation.

Comparative Analysis & Findings

  • Two female patients underwent assisted reproductive technologies (ART) and temporarily discontinued crizotinib, maintaining a complete remission (CR).
  • One male patient conceived naturally while on continuous crizotinib therapy.
  • All four patients achieved successful pregnancies without compromising disease control, demonstrating crizotinib's potential to support conception.

Implications and Future Directions

  • The study suggests that crizotinib may be safely used during pregnancy planning for patients with ALK+ ALCL, allowing them to maintain disease control.
  • Future studies should investigate the optimal management strategy for fertility preservation in patients with ALK+ ALCL.
  • Establishing specific guidelines on treatment discontinuation during pregnancy planning may help minimize the burden on patients and clinicians.