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Treatment of Early Stages Hodgkin Lymphoma During Pregnancy

BACKGROUND: To assess maternal and fetal outcome of women and newborns who received chemotherapy during pregnancy to treat Hodgkin lymphoma (HL)in early stages (IA, IIA), we performed a retrospective analysis of a cohort of 44 pregnant women with HL and early stages, diagnosed and treated between 19...

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Autores principales: Avilés, Agustin, Nambo, Maria-Jesus, Neri, Natividad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Università Cattolica del Sacro Cuore 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5760061/
https://www.ncbi.nlm.nih.gov/pubmed/29326803
http://dx.doi.org/10.4084/MJHID.2018.006
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author Avilés, Agustin
Nambo, Maria-Jesus
Neri, Natividad
author_facet Avilés, Agustin
Nambo, Maria-Jesus
Neri, Natividad
author_sort Avilés, Agustin
collection PubMed
description BACKGROUND: To assess maternal and fetal outcome of women and newborns who received chemotherapy during pregnancy to treat Hodgkin lymphoma (HL)in early stages (IA, IIA), we performed a retrospective analysis of a cohort of 44 pregnant women with HL and early stages, diagnosed and treated between 1988 to 2013, at a tertiary reference cancer center. METHODS: We analyzed data on HL characteristics and treatment, with a particular attention to maternal and fetal complications; in children, we performed a longer follow-up to detect any anomaly in physical development, scholar performance, psychological, cardiac, neurological function, and intelligence tests. RESULTS: Median age was 29.4 (range 21–37) years; Most patients were stage IIA (86%), had M a bulky mediastinal disease (78%) and 60% had > 3 nodal sites involved; thus these patients were considered to have a not favorable condition. Abortion was refused when it was proposed. All patients received chemotherapy during pregnancy; ABVD (adryamicin, bleomycin, vinblastine, and dacarbazine) at standard doses and schedule, even during the first trimester. Radiotherapy, when indicated, was administered after delivery in 39 patients. No obstetrical complications were observed, delivery occurred between 33 to 36 weeks in 10 cases (22%); and >37 weeks in 34 cases (87%). Four newborns were low-weight: 2012 g median (range 1750 – 2350 g). No clinical malformations were observed, and development of newborns was physiological without evidence of cardiac and neurological damage, behavior, intelligence, and scholar attendance were normal. At median follow-up range of 120.4 (48–299) months, the progression-free survival and overall survival of patients were 95% and 93%respectively CONCLUSION: Combined chemotherapy, as initial therapy appears to be the best approach in this setting of patients, with an excellent outcome to both mothers and children. If radiotherapy is necessary, it could be administered after delivery.
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spelling pubmed-57600612018-01-11 Treatment of Early Stages Hodgkin Lymphoma During Pregnancy Avilés, Agustin Nambo, Maria-Jesus Neri, Natividad Mediterr J Hematol Infect Dis Original Article BACKGROUND: To assess maternal and fetal outcome of women and newborns who received chemotherapy during pregnancy to treat Hodgkin lymphoma (HL)in early stages (IA, IIA), we performed a retrospective analysis of a cohort of 44 pregnant women with HL and early stages, diagnosed and treated between 1988 to 2013, at a tertiary reference cancer center. METHODS: We analyzed data on HL characteristics and treatment, with a particular attention to maternal and fetal complications; in children, we performed a longer follow-up to detect any anomaly in physical development, scholar performance, psychological, cardiac, neurological function, and intelligence tests. RESULTS: Median age was 29.4 (range 21–37) years; Most patients were stage IIA (86%), had M a bulky mediastinal disease (78%) and 60% had > 3 nodal sites involved; thus these patients were considered to have a not favorable condition. Abortion was refused when it was proposed. All patients received chemotherapy during pregnancy; ABVD (adryamicin, bleomycin, vinblastine, and dacarbazine) at standard doses and schedule, even during the first trimester. Radiotherapy, when indicated, was administered after delivery in 39 patients. No obstetrical complications were observed, delivery occurred between 33 to 36 weeks in 10 cases (22%); and >37 weeks in 34 cases (87%). Four newborns were low-weight: 2012 g median (range 1750 – 2350 g). No clinical malformations were observed, and development of newborns was physiological without evidence of cardiac and neurological damage, behavior, intelligence, and scholar attendance were normal. At median follow-up range of 120.4 (48–299) months, the progression-free survival and overall survival of patients were 95% and 93%respectively CONCLUSION: Combined chemotherapy, as initial therapy appears to be the best approach in this setting of patients, with an excellent outcome to both mothers and children. If radiotherapy is necessary, it could be administered after delivery. Università Cattolica del Sacro Cuore 2018-01-01 /pmc/articles/PMC5760061/ /pubmed/29326803 http://dx.doi.org/10.4084/MJHID.2018.006 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Avilés, Agustin
Nambo, Maria-Jesus
Neri, Natividad
Treatment of Early Stages Hodgkin Lymphoma During Pregnancy
title Treatment of Early Stages Hodgkin Lymphoma During Pregnancy
title_full Treatment of Early Stages Hodgkin Lymphoma During Pregnancy
title_fullStr Treatment of Early Stages Hodgkin Lymphoma During Pregnancy
title_full_unstemmed Treatment of Early Stages Hodgkin Lymphoma During Pregnancy
title_short Treatment of Early Stages Hodgkin Lymphoma During Pregnancy
title_sort treatment of early stages hodgkin lymphoma during pregnancy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5760061/
https://www.ncbi.nlm.nih.gov/pubmed/29326803
http://dx.doi.org/10.4084/MJHID.2018.006
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