Lymphoma Treatment in Pregnancy Does Not Compromise Fetal/Maternal Outcomes
San Diego, CA—The treatment of lymphoma during pregnancy does not compromise fetal outcomes or maternal health and cancer-specific survival, according to a study presented at ASH 2011 from the University of Massachusetts Medical School in Worcester. Cancer diagnosed during pregnancy is rare—20% are hematologic malignancies— and data on outcomes are scarce, said Andrew Evens, DO, who presented the findings. Dr Evens and his colleagues therefore conducted a retrospective analysis of patients treated at 9 medical centers between 1998 and 2011. They found 82 cases of lymphoma diagnosed during pregnancy, of which 43 were non-Hodgkin lymphoma and 39 were Hodgkin lymphoma. Six women, including 5 in the first trimester and 1 in the second, elected to terminate their pregnancies. Another 28 women, most of whom were in their third trimester, deferred treatment until after delivery. The remaining 48 patients began treatment at a median of 25 weeks gestation; 79% were in the second trimester. Treatment was usually with a standard regimen, modified to avoid antimetabolites.
Of these 48 patients, full-term deliveries occurred for 73%, compared with 86% who deferred therapy. The most common complication was the need to induce labor, which was observed in 45%. Complications were similar between women who were treated during pregnancy and those who postponed treatment, Dr Evens reported. Fetal outcomes were good and comparable to those in the general population of women without lymphoma. The 3-year overall survival rate was 92% for the patients who underwent treatment, 83% for those who deferred treatment, and 100% for those who terminated their pregnancies.—CH