Treating Blood Cancer During Pregnancy

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Lymphoma treatment during pregnancy safe for mother and baby

November 12, 2013 / Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

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(dailyRx News) Pregnancy is such an exciting time in a woman’s life. She’s caring for herself and the child growing inside her. Sometimes, but not often, this bliss is interrupted with a cancer diagnosis. A recent study looked at treating blood cancers during pregnancy.

A newly published study showed that treating lymphoma after the first trimester of pregnancy was safe for both the mother and baby.

Lymphoma is a group of blood cancers that start in the lymphatic system.

Combination chemotherapy was most commonly used to treat the disease and resulted in minimal complications for the mother or baby, according to the study.

"Learn how all medical treatments might impact your unborn child."

Researchers, led by Andrew M. Evens, DO, MSc, a physician scientist at Tufts Medical Center in Boston, MA, examined the effects of treating Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) during pregnancy.

Cancer is diagnosed during one out of 1,000 pregnancies, affecting between 3,500 and 4,000 women each year.

Lymphomas are the fourth most common cancer detected during pregnancy, the researchers reported.

A total of 90 pregnant women with Hodgkin lymphoma or non-Hodgkin lymphoma were recruited for this study from 11 academic centers between 1999 and 2011.

The median age of the women was 30 years, and they had been diagnosed with lymphoma at a median of 24 weeks of pregnancy.

Six of the pregnancies had to be terminated so that chemotherapy could begin immediately.

Among the remaining 84 participants, 33 percent (28 women) delayed treatment until after the birth of their babies.

The remaining 56 women underwent treatment for lymphoma during their pregnancies, including 89 percent of whom received combination chemotherapy regimens. Some of the women were treated with radiation therapy.

The researchers noted that the chemotherapies used were non-antimetabolite. Antimetabolites are a class of medications that interfere with DNA and RNA — the proteins that carry genetic information.

The most common treatment-related complication was pre-term induction of labor (using medication to start labor prior to 40 weeks), which was necessary for 33 percent of the treated women.

One-third of the women delivered their babies by cesarean section.

Delivery took place at a median of 37 weeks.

At 41 months, the researchers found that the progression-free survival (period during which the disease does not worsen) was 85 percent, and overall survival was 97 percent for Hodgkin lymphoma.

The researchers wrote, “In summary, we found that standard chemotherapy regimens for NHL and HL (without antimetabolites) administered during the second and third trimester, including as early as 13 weeks gestation in some cases, was associated with minimal maternal complications or fetal detriment.”

Findings from this study were published November 10 in the Journal of Clinical Oncology.

No conflicts of interest were disclosed.

Review Date: 
November 12, 2013
Last Updated:
December 31, 2013