Impact of different treatment approaches on pregnancy outcomes in 99 women treated for Hodgkin lymphoma

Int J Radiat Oncol Biol Phys. 2012 Nov 1;84(3):755-61. doi: 10.1016/j.ijrobp.2011.12.066. Epub 2012 Mar 11.

Abstract

Purpose: The aim of this study was to evaluate the pregnancy outcomes in women with Hodgkin lymphoma (HL) diagnosis, treated between 1972 and 1999 at Department of Radiotherapy and Hematology of University "Sapienza" of Roma.

Methods and materials: We retrospectively studied 99 female patients that conceived after treatment for HL. Fifty-nine (59%) were treated with chemotherapy and radiotherapy, 32 (32%) with radiotherapy alone as supradiaphragmatic or as infradiaphragmatic and 8 (8%) patients with chemotherapy alone.

Results: Ninety-nine patients reported 145 pregnancies. We observed 132 deliveries (2 of them twin births) after a median of 55 months (range, 14-278 months) from the end of therapy. Twelve women (12%) experienced 13 miscarriages after a median of 50 months (range, 13-120) from the end of therapy. We recorded 9/132 (7%) premature births and 3/134 babies (2%) were underweight at the time of birth. We recorded 2 cases of congenital malformations. No statistical differences were recorded when adverse pregnancy outcomes were analyzed with respect to chemotherapy alone, radiotherapy alone, or combined therapy.

Conclusions: No significant associations between pregnancy outcomes and therapeutic approaches were found. In particular, the infradiaphragmatic radiotherapy showed no statistical association with miscarriages, premature birth, and low birth weight at term when compared with other therapeutic approaches.

MeSH terms

  • Abortion, Spontaneous / epidemiology
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bleomycin / adverse effects
  • Congenital Abnormalities / epidemiology
  • Dacarbazine / adverse effects
  • Doxorubicin / adverse effects
  • Female
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / radiotherapy*
  • Humans
  • Mechlorethamine / adverse effects
  • Prednisone / adverse effects
  • Pregnancy
  • Pregnancy Complications, Neoplastic / drug therapy*
  • Pregnancy Complications, Neoplastic / radiotherapy*
  • Pregnancy Outcome / epidemiology*
  • Premature Birth / epidemiology
  • Procarbazine / adverse effects
  • Retrospective Studies
  • Vinblastine / adverse effects
  • Vincristine / adverse effects
  • Young Adult

Substances

  • Bleomycin
  • Procarbazine
  • Mechlorethamine
  • Vincristine
  • Vinblastine
  • Dacarbazine
  • Doxorubicin
  • Prednisone

Supplementary concepts

  • ABVD protocol
  • MOPP protocol