A case of chronic myelogenous leukemia in pregnancy characterized by a complex translocation t(9;22;11)(q34;q11.2;q13)

The management of chronic myelogenous leukemia during pregnancy requires balancing the well-being of the mother with that of the fetus. We report a case of a 26-year-old lady who was diagnosed with chronic myelogenous leukemia (CML) at 15 weeks gestation and who had an atypical chromosome t(9;22;11) (q34;q11.2;q13) translocation. She was observed through the remainder of the pregnancy and the disease remained stable; she delivered a normal boy. Treatment with imatinib mesylate was initiated shortly after delivery and she went into molecular complete remission. We discuss the course of the disease and suggest guidelines for managing pregnancy with respect to the currently available agents imatinib, dasatinib and nilotinib.