TREATMENT OF EARLY STAGES HODGKIN LYMPHOMA DURING PREGNANCY
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Keywords
Hematological malignancies and pregnancy, Hodgkin lymphoma and pregnancy, Chemotherapy during pregnancy
Abstract
Objetive. To assess maternal and fetal outcome of women who receiving chemotherapy during pregnancy to treat Hodgkin lymphoma(HL) in early stages (IA and IIA), we performed an retrospective analysis of 44 women with HL at early stage, diagnosed and treated between 1988 to 2010, in a tertiary reference cancer center.
Methods:We analyze data of HL: clinical characteristics and treatment; and special attention to maternal and fetal complications ; children : physical development, assess scholar performance phsycological, cardiac and neurological function and intellegence tests.
Results: Forty-four pregnant women were enrolled. Median age was 29.4 (range 21-37)years; most patients were stage IIA (86%), had mediastinal bulky disease (78%) and > 3 nodal sites involved; thus these patients were recorded to have a not favourable condition. Abortion was refused when proposed. All patients received combined chemotherapy: ABVD) ( adryamicin, bleomycin, vinblastine and dacarbazine), even during first trimester, at standar doses and schedules. Radiotherapy, when necessary was administered after delivery in 39 patients. No obstetrical complications were observed. Delivery ocurred between 31 to 36 weks in 10 patients (22%) and > 37 weeks in 34 cases (77%). Four newborns were low-weight: 2012 (median) (range:1750 -2350) g. No clinical malformations were observed and development of children were normal without evidence of cardiac, neurological damage. Behavior, scholar attendance and intellegence tests were normal. With a median follow-up of 120.4 (range 48-299) months, progression-free survival and overall survival were 93% and 95 %, respectively.
Conclusion: Chemotherapy as initial therapy appear to be thes best therapeutic approach in these setting of patients, with a excelent outcome to both: mother and children. If radiotherapy is necessary, could be administered after delivery
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