Study Suggests Treating Lymphoma during Pregnancy Does Not Increase Risk to Mother or Child
Lymphoma is the fourth most frequent cancer diagnosed in pregnancy, but in-depth studies of this patient population have been limited. Several researchers with ties to the Lymphoma Research Foundation (LRF) helped address this issue by contributing to a recently published study examining the treatment, complications, and outcomes for women who receive a diagnosis of lymphoma during pregnancy. The study appears in the November 10, 2013 issue of the Journal of Clinical Oncology.
The researchers analyzed the treatment of 90 patients treated at multiple institutions for both Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). One third (33 percent) of the group deferred treatment until after giving birth, with the other two-thirds (67 percent) beginning treatment during pregnancy. The study found no significant difference in the types of complications (most often early labor) or median infant birth weight between the two groups, with the majority of patients in both groups (57 percent) reaching full term. The results suggest that women diagnosed with lymphoma during their pregnancies can begin treatment as early as 13 weeks without measurably increasing the risks to themselves or their child. Corresponding author Andrew M. Evens, DO, MSc of Tufts Medical Center, said that, in addition to suggesting chemotherapy during pregnancy was safe, the study also identified low-risk scenarios, such as a low total mass of tumor tissue and a diagnosis late in a pregnancy, where it was safe to defer treatment until after the birth.
Dr. Evens, who has served as faculty for several of LRF's patient education programs as well as LRF's upcoming Clinical Research Mentoring Program, further noted that this study is one of the largest reports to examine lymphoma occurring during pregnancy. "Treatment recommendations should always be personalized and ultimately tailored to the patients' wishes," Dr. Evens added. "We are hopeful that our data provides clinicians and patients with information to help guide these critical decisions… In all cases, care should be closely coordinated with high-risk maternal-fetal medicine and an overarching goal should be to continue the pregnancy to full term."
Several LRF Scientific Advisory Board (SAB) members also contributed to the study, including Ranjana Advani, MD (Stanford University), Oliver W. Press, MD, PhD (Fred Hutchinson Cancer Research Center), Izidore S. Lossos, MD (University of Miami), Julie M. Vose, MD, MBA (University of Nebraska Medical Center), Leo I. Gordon, MD (Northwestern University), Kristie A. Blum, MD (Ohio State University), Christopher R. Flowers, MD, MS (Winship Cancer Institute, Emory University), John P. Leonard, MD (Weill Cornell), Thomas M. Habermann, MD (Mayo Clinic), and Nancy L. Bartlett, MD (Washington University in St. Louis).
The abstract of the paper, "Lymphoma Occurring During Pregnancy: Antenatal Therapy, Complications, and Maternal Survival in a Multicenter Analysis," is available online through the Journal of Clinical Oncology website.