Lymphomas in pregnancy

Abstract

Lymphoma in pregnancy is an uncommon occurrence. This diagnosis is challenging, and a multidisciplinary team of specialists in obstetrics, anesthesiology, neonatology, hematology psychology should participate in the management of this condition. The choice of treatment regimen depends on the histotype and the gestational age. In Hodgkin lymphoma, ABVD is safe if administered after the thirteenth week of pregnancy. In indolent non-Hodgkin Lymphomas (NHL) a watchful waiting approach is reasonable; in case of aggressive NHLs, if the diagnosis occurs in the first gestational weeks, a termination of the pregnancy might be considered or if it occurs after the thirteenth week of pregnancy, a standard R-CHOP regimen is safe. Regarding new anti-lymphoma drugs, available data on the potential fetotoxicity of these agents are limited. Data collection regarding the use of new drugs in pregnant patients is mandatory in order to learn more about their safety and facilitating clinical decision making in this setting of patients.

Cancer During Pregnancy and Possible Treatment Options - Literature Review

“…The choice of the optimal treatment regimen depends on the trimester of pregnancy at the time of diagnosis, the histological type of cancer, the stage of disease advancement and the presence of life-threatening symptoms. [48,49] Hodgkin's lymphoma is diagnosed in 1:3,000, while non-Hodgkin's lymphomas (diffuse large B-cell lymphoma, T-cell lymphoma, Burkitt's lymphoma and clinically advanced immunoblastic lymphoma) are diagnosed in 1:5,000 pregnancies. The pathogenesis, clinical picture, response to therapy and overall survival after optimal treatment of lymphoma in pregnant women do not differ from those in non-pregnant women.…”

“…However, the late age of the pregnant woman influences the increase in the frequency of non-Hodgkin's lymphoma diagnoses. [56,49] The diagnostic test used to assess the size of lymphoma is ultrasound. To determine the stage of progression, a physical examination is used (particular attention should be paid to the presence of B symptoms), laboratory tests, and sometimes also a bone marrow trepanobiopsy.…”