Ph-negative myeloproliferative neoplasms usually occur in patients around 60 years but can also be diagnosed at a younger age. In pregnancy, there is a high risk of complications that include thrombo-embolic, bleeding or placental dysfunction.
A successful pregnancy is observed in 70% of women with myeloproliferative neoplasms. Aspirin therapy and administration of low molecular weight heparin are recommended for low-risk polycythemia vera, cytoreductive therapy with interferon for high-risk polycythemia vera.
Interferon does not significantly increase the risk of major malformation, miscarriage, stillbirth, or preterm delivery. In addition, all women with polycythemia vera should maintain strict hematocrit control < 45% with the aid of phlebotomy.
This case report illustrates the possibility of safe use of using ropeginterferon alfa-2b in pregnant patients with high-risk polycythemia vera.