Eculizumab treatment in pregnant women with paroxysmal nocturnal hemoglobinuria: A Polish experience

Adv Clin Exp Med. 2022 Jun;31(6):707-710. doi: 10.17219/acem/150600.

Abstract

Background: Eculizumab is an antibody targeting the C5 complement protein. Clinical trials suggest that eculizumab significantly reduces transfusion requirements and prevents disease complications in patients with paroxysmal nocturnal hemoglobinuria (PNH).

Objectives: To analyze the outcome of pregnancies among Polish women with PNH treated with eculizumab as a part of the Polish National Health Fund program.

Material and methods: We report the outcomes of 3 pregnancies among women treated with eculizumab between 2017 and 2020. For 1 of these woman, it was the 1st pregnancy, while the remaining 2 patients had previously had 1 previous successful pregnancy each.

Results: All 3 mothers survived pregnancy, and all children were born alive. One of the patients had a vaginal delivery. Another required cesarean delivery at the 34th week due to a decreasing platelet count. In 1 case, premature rupture of the fetal membranes occurred at week 36, followed by artificial labor induction. All children were born without any inborn defects. The 2 prematurely born babies required a prolonged hospital stay.

Conclusion: Treatment with eculizumab seems to reduce the risk to a mother and a child associated with PNH. However, more data are necessary to confirm this notion.

Keywords: PNH; eculizumab; pregnancy.

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Child
  • Complement Inactivating Agents / therapeutic use
  • Female
  • Hemoglobinuria, Paroxysmal* / drug therapy
  • Humans
  • Poland
  • Pregnancy
  • Pregnant Women

Substances

  • Antibodies, Monoclonal, Humanized
  • Complement Inactivating Agents
  • eculizumab