Abstract
This cohort study of the International Network on Cancer, Infertility and Pregnancy (INCIP) reports the maternal and neonatal outcomes of 80 pregnant patients diagnosed with non-Hodgkin lymphoma (NHL) between 1986 and 2019, focussing on 57 (71%) patients with diffuse large B-cell lymphoma (DLBCL). Of all 80 patients, 54 (68%) pregnant patients received chemotherapy; mostly (89%) CHOP-like (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimens. Four early pregnancies were terminated. Among 76 ongoing pregnancies, there was one stillbirth (1·3%). Overall, there was a high incidence of small for gestational age neonates (39%), preterm delivery (52%), obstetric (41%) and neonatal complications (12·5%), and this could not exclusively be explained by the receipt of antenatal chemotherapy. Half of preterm deliveries (46%) were planned in order to tailor oncological treatment. The 3-year progression-free and overall survival for patients with DLBCL treated with rituximab-CHOP was 83·4% and 95·7% for limited stage (n = 29) and 60·6% and 73·3% for advanced stage (n = 15). Of 36 pregnant patients who received rituximab, five (13%) cases with neonatal complications and three (8%) with maternal infections were reported. In conclusion, standard treatment for DLBCL can be offered to pregnant patients in obstetric centres that cater for high-risk patients.
Keywords:
R-CHOP; diffuse large B-cell lymphoma; maternal outcome; non-Hodgkin lymphoma; pregnancy.
© 2020 British Society for Haematology and John Wiley & Sons Ltd.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Adult
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Antibodies, Monoclonal, Murine-Derived / therapeutic use
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Antineoplastic Agents, Immunological / therapeutic use
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / adverse effects*
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Congenital Abnormalities / epidemiology
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Cyclophosphamide / administration & dosage
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Cyclophosphamide / adverse effects
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Cyclophosphamide / therapeutic use
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Doxorubicin / administration & dosage
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Doxorubicin / adverse effects
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Doxorubicin / therapeutic use
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Female
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Fetal Growth Retardation / chemically induced
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Fetal Growth Retardation / epidemiology
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Gestational Age
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Humans
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Incidence
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Infant, Newborn
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Infertility / chemically induced
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Infertility / epidemiology
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Lymphoma, Large B-Cell, Diffuse / complications
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Lymphoma, Large B-Cell, Diffuse / diagnosis*
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Lymphoma, Large B-Cell, Diffuse / drug therapy*
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Lymphoma, Large B-Cell, Diffuse / pathology
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Lymphoma, Non-Hodgkin / diagnosis*
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Lymphoma, Non-Hodgkin / drug therapy*
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Lymphoma, Non-Hodgkin / mortality
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Lymphoma, Non-Hodgkin / pathology
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Prednisolone / administration & dosage
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Prednisolone / adverse effects
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Prednisolone / therapeutic use
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Pregnancy
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Pregnancy Complications / chemically induced
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Pregnancy Complications / epidemiology
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Pregnancy Outcome / epidemiology
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Premature Birth / chemically induced
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Premature Birth / epidemiology
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Progression-Free Survival
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Retrospective Studies
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Rituximab / therapeutic use
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Stillbirth / epidemiology
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Vincristine / administration & dosage
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Vincristine / adverse effects
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Vincristine / therapeutic use
Substances
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Agents, Immunological
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Prednisolone