Treatment of chronic phase of CML in pregnant women is –
**Core Concept**
Chronic Myeloid Leukemia (CML) is a myeloproliferative disorder characterized by the overproduction of mature and immature granulocytes, often associated with the BCR-ABL fusion gene resulting from a Philadelphia chromosome. In the chronic phase, CML can be effectively managed with targeted therapy.
**Why the Correct Answer is Right**
In pregnant women with CML, the primary concern is the safety of both the fetus and the mother. Imatinib, a tyrosine kinase inhibitor (TKI), is the preferred treatment in the chronic phase due to its efficacy and relatively favorable safety profile in pregnancy. Imatinib inhibits the BCR-ABL tyrosine kinase, thereby reducing leukemic cell proliferation. Its use has been well-documented in pregnant women, with a favorable outcome for both the mother and the fetus.
**Why Each Wrong Option is Incorrect**
**Option A:** Hydroxyurea is an older chemotherapy agent that can be used in CML, but it is not the preferred treatment in the chronic phase due to its potential side effects and the availability of more effective targeted therapies like Imatinib.
**Option B:** Interferon-alpha was historically used to treat CML, but it is not the preferred treatment in the chronic phase due to its lower efficacy and higher toxicity compared to TKIs like Imatinib.
**Option C:** High-dose chemotherapy with stem cell transplantation is a treatment option for CML, but it is not typically used in pregnant women due to the risks associated with the procedure and the potential impact on the fetus.
**Clinical Pearl / High-Yield Fact**
Imatinib is generally considered safe in pregnancy and has been used effectively in pregnant women with CML. However, careful monitoring of both the mother and the fetus is essential, and the decision to use Imatinib should be made in consultation with a high-risk obstetrician and a hematologist.
**Correct Answer: A. Imatinib.**