Barbui and other members of the European LeukemiaNet listed therapeutic options for a pregnant woman with a myeloproliferative neoplasm. The authors are from multiple hospitals in Europe participating in the European LeukemiaNet.
Parameters:
(1) risk level of the myeloproliferative disorder
(2) history of bleeding
(3) thrombosis
(4) platelet count in essential thrombocythemia (ET)
(5) hematocrit in polycythemia vera (PV)
Risk Level
Diagnosis
Clinical
Therapy
low risk
NA
NA
prophylactic dose LMWH after delivery for 6 weeks
low or high risk
NA
not bleeding
low dose aspirin (stop if bleeding)
low or high risk
PV
NA
hematocrit < 45% or midgestation specific range, whichever lower
high risk
NA
thrombosis or severe pregnancy complication
prophylactic dose LMWH until 6 weeks after delivery
high risk
ET
platelet count > 1.5 M per µL
interferon alfa
high risk
ET
bleeding
interferon alfa
where:
• LMWH = low molecular weight heparin
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