Lymphoma and leukemia occurring during pregnancy

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology Pub Date : 2025-03-01 DOI:10.1016/j.semperi.2025.152041

Adam S. Zayac, Ogechukwu Egini, Neil D. Palmisiano, Andrew M. Evens

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Abstract

Malignancies arising during pregnancy are an infrequent occurrence, leading to a paucity of data on the optimal management of cancers during pregnancy. Unlike most solid tumors, the primary, and often curative, management of hematologic malignancies relies heavily on multiagent cytotoxic chemotherapies over surgery and other localized therapies, making their management during pregnancy even more complex and hazardous to both mother and fetus. Close multidisciplinary care and coordination between obstetrician, maternal fetal medicine, and oncologists are essential given the dangers to both in the management, from diagnosis and throughout treatment, even through delivery and survivorship. Due to the importance of this topic and the number of lives that could be impacted, guidelines have been published by interdisciplinary expert panels based on available data and clinical experience. This review addresses the management of both Hodgkin and non-Hodgkin lymphomas as well as acute and chronic leukemias. The optimal diagnostic approaches, and therapeutic schemes, including the use of cellular therapies, immunotherapies, targeted and cytotoxic agents, as well as guidance on decision making regarding management of the pregnancy weighing both the maternal and fetal risks and benefits of each approach are discussed herein.

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怀孕期间发生的淋巴瘤和白血病

怀孕期间发生的恶性肿瘤并不常见，导致缺乏关于怀孕期间癌症最佳管理的数据。与大多数实体肿瘤不同，恶性血液病的原发性和可治愈性治疗严重依赖于多药细胞毒性化疗，而不是手术和其他局部治疗，这使得其在怀孕期间的治疗更加复杂，对母亲和胎儿都有危险。产科医生、母胎医学和肿瘤学家之间密切的多学科护理和协调是至关重要的，因为从诊断到整个治疗，甚至到分娩和生存，在管理中都存在危险。由于这一主题的重要性以及可能受到影响的生命数量，跨学科专家小组根据现有数据和临床经验发布了指南。本文综述了霍奇金淋巴瘤和非霍奇金淋巴瘤以及急性和慢性白血病的治疗。本文讨论了最佳诊断方法和治疗方案，包括细胞疗法、免疫疗法、靶向药物和细胞毒性药物的使用，以及权衡每种方法对母体和胎儿的风险和益处的妊娠管理决策指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in perinatology 医学-妇产科学

CiteScore

5.80

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： The purpose of each issue of Seminars in Perinatology is to provide authoritative and comprehensive reviews of a single topic of interest to professionals who care for the mother, the fetus, and the newborn. The journal''s readership includes perinatologists, obstetricians, pediatricians, epidemiologists, students in these fields, and others. Each issue offers a comprehensive review of an individual topic, with emphasis on new developments that will have a direct impact on their practice.