Treatment of essential thrombocythemia during pregnancy with interferon-alpha

Only a few cases of essential thrombocythemia in pregnant women have been reported, and the management of this myeloproliferative disorder during pregnancy remains uncertain. We report a successful pregnancy in a patient who had essential thrombocythemia and who was treated with interferon-alpha, and we review the literature for the outcome of similar patients.

A 32-year-old woman, gravida 4, para 3, aborta 0, presented at 18 weeks' gestation with two episodes of amaurosis fugax and an elevated platelet count of 2300 x 10(9)/L. The initiation of interferon-alpha led to a progressive fall of the platelet level, with no occurrence of thrombotic or hemorrhagic manifestations. Serial ultrasound examinations revealed normal fetal and placental development. The patient was delivered of a male infant at 37 weeks. Both child and placenta were normal on examination.

Our case and the current available data suggest that interferon-alpha may be the best therapeutic option for pregnant patients with essential thrombocythemia in whom myelosuppression is required.