Among women who are diagnosed with lymphoma during pregnancy, the outcomes for both mother and baby are often good. This was true for women who began lymphoma treatment during the second or third trimester of pregnancy, as well as women who deferred treatment until after delivery. These results were presented at the 2011 annual meeting of the American Society of Hematology.
Lymphoma refers to cancer that involves the cells of the immune system. Two broad categories of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). Several different subtypes of non-Hodgkin lymphoma have been identified, some of which are slow-growing and some of which are more aggressive. Different types of lymphoma require different approaches to treatment.
Having lymphoma diagnosed during pregnancy is uncommon, and relatively little information has been available about the management and outcome of lymphoma in pregnant women. To explore this issue, researchers collected information about 82 women who had been diagnosed with lymphoma during pregnancy. The women were diagnosed at one of nine largeUSmedical centers between 1998 and 2011.
The median age of the women was 31. Fifteen percent of the women were diagnosed with lymphoma in the first trimester of pregnancy, 46 percent were diagnosed in the second trimester, and 35 percent were diagnosed in the third trimester.
- 48 women (63 percent) started lymphoma treatment during pregnancy. Treatment began no earlier than the second trimester of pregnancy.
- 28 women (37 percent) delayed lymphoma treatment until after delivery. A majority of these women were diagnosed with lymphoma late in the third trimester.
- Six patients terminated the pregnancy and received immediate chemotherapy. Five of these patients were in the first trimester of pregnancy and one was early in the second trimester and required treatment with high-dose methotrexate.
- Of the women who continued pregnancy, the median gestational age at the time of delivery was 37 weeks among those who started treatment during pregnancy and 38 weeks among those who delayed treatment until after delivery.
- Birth weight was similar in the two groups. There was one still-birth and one infant with a major birth defect among the women who received lymphoma treatment during pregnancy.
- Three-year overall survival among the women was 92 percent among those who started treatment during pregnancy, 83 among those who started treatment after delivery, and 100 percent among those who terminated the pregnancy.
Since each woman’s situation is different, decisions about how best to manage lymphoma diagnosed during pregnancy will need to be individualized. The results of this study, however, suggest that many women experience good pregnancy outcomes as well as good lymphoma outcomes.
Reference: Evens AM, Advani RH, Lossos IS et al. Lymphoma in pregnancy: excellent fetal outcomes and maternal survival in a large multicenter analysis. Presented at the 53rd ASH Annual Meeting and Exposition.San Diego,CA, December 10-13, 2011. Abstract 623.
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