Successful Pregnancy After Planned Pregnancy-Oriented TKI Interruption and Embryo Transfer Following Ponatinib Re-Consolidation in Chronic-Phase Chronic Myeloid Leukemia.

INTRODUCTION

Pregnancy after unsuccessful treatment-free remission (TFR) in chronic-phase chronic myeloid leukemia (CP-CML) remains challenging.

CASE PRESENTATION: A woman lost major molecular response (MMR) after stopping a BCR::ABL1 tyrosine kinase inhibitor (TKI). Ponatinib re-consolidation enabled a second TKI-free interval, with MMR maintained but deep molecular response unstable. With diminished ovarian reserve, embryos were cryopreserved using assisted reproductive technology (ART), separating fertility preservation from pregnancy timing. Further ponatinib re-consolidation restored MR4.5; ponatinib was stopped before embryo transfer, resulting in pregnancy and live birth without TKI exposure.

CONCLUSION

Sequential ponatinib re-consolidation and ART may enable planned TKI interruption for pregnancy.

TRIAL REGISTRATION: The authors have confirmed clinical trial registration is not needed for this submission.