[Management of fertility and pregnancy in patients with chronic myeloid leukemia]

The introduction of tyrosine kinase inhibitors (TKIs) as treatment for patients with chronic myeloid leukemia (CML) has dramatically improved the outcomes. The life expectancy of patients with CML is now comparable to that of the general population. Although the median age of onset of CML is around 60 years, it can also occur in children, adolescents, and young adults. The excellent disease control gives young patients a hope of childbearing. However, TKIs may have teratogenic potentials in the issue of fertility and pregnancy. One possible scenario is to discontinue TKI treatment for conception and pregnancy because treatment-free remission (TFR) is a realistic option for patients with CML in sustained deep molecular remission. Conversely, pregnancy occurs in patients who are ineligible for TFR or who have active CML. Therefore, several treatment strategies should be prepared from the viewpoint of the situation of pregnancy in patients with CML.