Diagnosis and treatment of malignant lymphomas in pregnancy and lactation, our own experiences



Year of publication 2008
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Description Background: The lymphomas represent the fourth most frequent malignancy diagnosed during pregnancy, occuring in approximately 1:6000 deliveries. Considerably more often is a diagnosis of the Hodgkins lymphoma, possibly because of the natural incidence of this disease in the reproductive age of the patients. Material and methods: Since 2001 there were diagnosed 17 patients with a lymphoma during pregnancy or lactation at our clinic. The median age of the patients was 27 years. The histological types of lymphomas were in most of the cases Hodgkins lymphoma (N=13), then diffuse large B-cell lymphoma (N=3) and MALT lymphoma of a eye-lid (N=1). The diagnosis was determined in the 1st (N=2), the 2nd (N=4) and the 3rd trimester (N=4) of pregnancy, at the other 7 patients during lactation (4 of them had a fever or swelling nodes aready during the pregnancy). In most of the cases the patients were diagnosed at clinical stage II. Results: 3 of the patients diagnosed during the 1st and the 2nd trimester had an abortion on their own request, 11 patients gave birth to a healthy child naturally (N=7) or by Caesarean section (N=4). In three cases the disease was diagnosed in a critical state of the patients (superior vena cava syndrome or an obstructive ileus), requiring an abortion because of the medical indication of the mother. In the therapeutic plan a histological type of the lymphoma and a clinical stage of the disease were respected. All the patients initiated the treatment after the ending of the pregnancy. The complete remission was achieved at all the patients. 4 of the patients gave birth to a healthy child after the completion of the treatment, the other 2 are currently pregnant. Conclusions: The cases of the diagnosis of the malignant lymphoma during pregnancy are increasing together with the tendency to the family planning in the older age of the mother. However, the pregnancy doesnt affect the overall survival as well as it doesnt influence the prognosis of the disease negatively. The diagnosis of the malignant lymphoma during pregnancy requires a specific and individual attitude while planning the staging examinations and the therapeutical programme has to take into account the wish of the patient.

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