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Diffuse Large B-Cell Lymphoma During Third-Trimester Pregnancy and Lactation.

Alicia E Hersey¹, Patricia Giglio, Habibe Kurt

¹Warren Alpert Medical School of Brown University, the Department of Pathology and Laboratory Medicine, Lifespan Academic Medical Center, and the Department of Medicine, Women and Infants Hospital, Providence, Rhode Island.

Obstetrics and Gynecology

|January 11, 2020

Summary

Diffuse large B-cell lymphoma (DLBCL) in pregnancy requires careful management balancing maternal and fetal risks. This case highlights successful delivery, postpartum chemotherapy, and breastfeeding protocols for pregnant patients with DLBCL.

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Area of Science:

Oncology
Maternal-Fetal Medicine
Hematology

Background:

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin's lymphoma during pregnancy.
DLBCL tumors can be aggressive and grow rapidly in pregnant individuals.
Management necessitates balancing oncologic treatment risks with fetal well-being.

Observation:

A case of DLBCL diagnosed in the third trimester of pregnancy is presented.
The patient underwent labor induction at 34 weeks gestation.
Postpartum chemotherapy and a timed lactation protocol were initiated.

Findings:

The case demonstrates a successful approach to managing aggressive lymphoma during pregnancy.
Key considerations included staging, antenatal steroids, delivery timing, and lactation during chemotherapy.
Multidisciplinary care is crucial for optimizing outcomes.

Implications:

This case underscores the importance of a comprehensive approach to lymphoma in pregnancy.
It provides a framework for managing oncologic emergencies while prioritizing fetal and maternal health.
Further research into optimal timing for delivery and lactation protocols is warranted.