CCoPE
Date: 2002-10-15

Question:
I have Essential Thrombocythemia, and I want to get pregnant again. I had one successful pregnancy and am desperate to have another one. I am on Agrylin Therapy and it is working. I know that my risks are high, but are there any platelet lowering drugs that I could take during pregnancy and what are my chances of losing the baby or having something wrong with the baby and what are my risks?

Answer:
The following information should not replace the assessment and advice you have been receiving from your physician (cancer specialist, obstetrician, or any other healthcare provider). It is offered for your information only

There are many reports of women with essential thrombocythemia (ET) and normal pregnancy outcome. There have been no published reports of the use of Agrylin (anagrelide) in pregnancy. Some women experience a spontaneous reduction in platelet count during pregnancy, and they do not need therapy at all. It depends on the platelet level, if it is not extremely high some anti-clotting therapy could be used. Most authorities recommend that pregnant women be treated with interferon during pregnancy probably in combination with aspirin. However, there is no good data to support this. There is limited data on the safety of interferon in pregnancy. Three studies have suggested that there is no placental transfer, which would support its use in pregnancy. Also, there have been over 40 case reports of exposure to interferon in pregnancy with normal outcomes, which is very reassuring. Consult your doctor.