Breast feeding while on Gleevec

[Guest guest]

I am gravely concerned about a member who posted recently that she was breast

feeding her baby while on Gleevec. I want her to know that I am not judging her,

but merely reiterating what has been passed down to us repeately. In speaking

directly to her, I hope you have permission, dear member from your doctor or you

could be playing Russian roulette with your baby's health. This is the warning

that comes with Gleevec. Women who want to become pregnant should not do so

while taking Gleevec or any other TKI. If you need further proof, I urge you

to please contact the Novartis Hotline or the instructions that comes in your

package. This comes from their webpage:

Who should NOT take GLEEVEC

Women who are or could be pregnant. Fetal harm can occur when administered to

pregnant women; therefore, women should not become pregnant, as well as be

advised of the potential risk to the unborn child if GLEEVEC is used during

pregnancy.

" Women who are breast-feeding because of the potential for serious adverse

reactions in nursing infants.

" Sexually active females should use adequate birth control while taking GLEEVEC.

" Be sure to talk to your doctor and/or healthcare professional about these

issues before taking GLEEVEC "

http://tinyurl.com/29fl97v

--_________________

I further give you warnings from the following information published in the

Internet Journal of Oncology. This article was written by Ault MS, RN,

FNP-BC, ANP-BC Family Nurse Practitioner, Adult Nurse Practitioner School of

Nursing The University of Texas Health Science Center at Houston and I quote

from her article (noted in 2010 Volume 7 Number 2).

I have known Pat Ault for a long time, also most of the doctors in that

department. She would not have been given permission to write this article

without the blessings of the doctors at MDACC that she works under and I respect

her authority on the subject of CML.

You will note that everything I copied is in " quotations " . Some quotes I have

excerpted are posted here, but the entire article can be seen at the recited

website listed below the quotes, however, it is very lengthy:

" Management of CML during pregnancy poses challenges to both hematologists and

obstetricians. Currently, consensus is lacking in management of CML in

pregnancy; therefore, clinical observations have become important. Most of these

observations are derived from small case series or case reports.

" Therefore, leukapheresis may be an intermittent short-term alternative option

for pregnant patients, and prevents fetal exposure to TERATOGENIC drugs.

However, leukapheresis is cumbersome, costly, and a time consuming procedure,

with risk of infection, thrombosis and hypotensive events that may affect the

fetus and patient.

" ........... high concentrations of imatinib are DETECTED IN BREAST MILK.

" Investigation of the placentas included standard pathologic analysis, computer

assisted morphometry, and fluorescence in situ hybridization (FISH) analysis.

This patient was treated with a targeted tyrosine inhibitor during first

trimester of a first pregnancy and during the third trimester of a second

pregnancy. The umbilical cord blood and breast milk findings were: 1) low

imatinib and metabolite concentration levels found in the umbilical blood

suggest limited placental transfer in late pregnancy, and 2) HIGH CONCENTRATION

LEVELS OF IMATINIB AND METABOLITES WERE FOUND IN THE BREAST MILK.

" Rousselot et al (2007) reported imatinib may be discontinued in patients who

achieved a complete molecular remission for a period of at least 2 years without

evidence of disease progression.

" Gambacorti-Passerini et al (2009) reported the IMATINIB CONCENTRATION IN BREAST

MILK REACHES A STEADY-STATE LEVEL AT 0.8 ug/ml. The milk intake in infants is

known to average 728 to 777 ml/d, (range of 450 to 1165 ml/d); considering this

milk intake and the infants are unlikely to receive more than 3 mg/d imatinib

daily. This amount is far from therapeutic range, therefore, concluding that

mothers with CML could safely breast-feed the infant. However, the effects of

low-dose chronic exposure of infants to imatinib are not known, and have not

undergone long-term investigation; THEREFORE, BREAST FEEDING SHOULD NOT BE

RECOMMENDED AFTER RESUMING THERAPY.

ttp://tinyurl.com/2g82tpc

FYI,

Lottie Duthu