Managing Lymphoma during pregnancy

Athena Kritharis, Elizabeth P. Walsh, Andrew Evens

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Lymphoma is one of the most common cancers that occurs during pregnancy. Primarily due to its usual peak onset in reproductive years, Hodgkin lymphoma (HL) occurs slightly more often during pregnancy than non-Hodgkin lymphoma (NHL). Prompt diagnosis to determine the exact lymphoma subtype is important, and specific staging studies are recommended for lymphoma occurring during pregnancy. NHLs are typically an aggressive subtype, commonly occur later in gestation, diagnosed at a more advanced stage, and often involve the reproductive organs. Treatment recommendations are based in part on the clinical scenario and patient/family wishes. Overarching goals for the treatment of pregnant mothers with lymphoma should be to concurrently optimize maternal survival and minimize treatment-related fetal toxicity and prematurity. This is maximized by close collaboration with high-risk maternal-fetal medicine and also with a goal of continuing pregnancy to full term (i.e., beyond 37 weeks). The decision to administer chemotherapy, radiation, and/or other therapeutic agents during gestation is individualized with the risk of antenatal therapy weighed against the potential adverse effects of delaying curative therapy. Overall, there should be consideration to delay anti-lymphoma treatment until after the first trimester and in select scenarios after delivery (e.g., asymptomatic indolent lymphomas, diagnosis in late third trimester, etc.), while antenatal therapy during the second and third trimesters is tenable in many cases (i.e., beyond 12 weeks). This detailed review describes available data on disease presentation and patient characteristics, gestational data, treatment (including targeted therapeutics), maternal and fetal complications, and additional considerations for patients diagnosed with NHL and HL during pregnancy.

Original languageEnglish (US)
Title of host publicationManaging Cancer During Pregnancy
PublisherSpringer International Publishing
Pages159-173
Number of pages15
ISBN (Electronic)9783319288000
ISBN (Print)9783319287980
DOIs
StatePublished - Jan 1 2016

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Lymphoma
Pregnancy
Mothers
Therapeutics
Third Pregnancy Trimester
Hodgkin Disease
Non-Hodgkin's Lymphoma
Delayed Diagnosis
Second Pregnancy Trimester
First Pregnancy Trimester
Medicine
Radiation
Drug Therapy
Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Kritharis, A., Walsh, E. P., & Evens, A. (2016). Managing Lymphoma during pregnancy. In Managing Cancer During Pregnancy (pp. 159-173). Springer International Publishing. https://doi.org/10.1007/978-3-319-28800-0_14
Kritharis, Athena ; Walsh, Elizabeth P. ; Evens, Andrew. / Managing Lymphoma during pregnancy. Managing Cancer During Pregnancy. Springer International Publishing, 2016. pp. 159-173
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Kritharis, A, Walsh, EP & Evens, A 2016, Managing Lymphoma during pregnancy. in Managing Cancer During Pregnancy. Springer International Publishing, pp. 159-173. https://doi.org/10.1007/978-3-319-28800-0_14

Managing Lymphoma during pregnancy. / Kritharis, Athena; Walsh, Elizabeth P.; Evens, Andrew.

Managing Cancer During Pregnancy. Springer International Publishing, 2016. p. 159-173.

Research output: Chapter in Book/Report/Conference proceedingChapter

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Kritharis A, Walsh EP, Evens A. Managing Lymphoma during pregnancy. In Managing Cancer During Pregnancy. Springer International Publishing. 2016. p. 159-173 https://doi.org/10.1007/978-3-319-28800-0_14