Leukemia and lymphoma in pregnancy

Area of Science:

• Oncology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Chemotherapy administration during pregnancy poses significant therapeutic, ethical, and social challenges.
• Limited data from retrospective series and case reports complicate clinical decision-making for treating pregnant patients with cancer.
• Standard cancer diagnosis and staging are adapted, excluding procedures with fetal radiation exposure.

Purpose of the Study:

• To review the considerations and challenges associated with chemotherapy treatment in pregnant women.
• To outline the risks and decision-making processes regarding fetal exposure to chemotherapy.

Main Methods:

• Review of existing literature on chemotherapy use in pregnancy.
• Analysis of diagnostic and treatment adaptations for pregnant cancer patients.

Main Results:

• Chemotherapy is contraindicated in the first trimester due to the risk of fetal malformations, necessitating treatment delay or termination.
• In later stages of pregnancy, chemotherapy initiation is often performed without delay.
• Current evidence suggests no apparent teratogenicity with chemotherapy initiated later in pregnancy.

Conclusions:

• Managing cancer in pregnant women requires careful consideration of gestational timing and potential fetal risks.
• Treatment strategies must balance maternal health needs with fetal well-being, often involving delayed or modified chemotherapy regimens.
• Further research is needed to fully understand the long-term effects of chemotherapy on fetuses exposed during different trimesters.