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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.
Background:
Diffuse large B-cell lymphoma is the most common type of non-Hodgkin's lymphoma affecting pregnancy. These tumors may be aggressive and rapidly growing in pregnancy. Management is based on the balance of risks and benefits to both the pregnant patient and the fetus.
Case:
We present a case of diffuse large B-cell lymphoma diagnosed in the third trimester of pregnancy. The patient underwent labor induction at 34 weeks of gestation, started a standard chemotherapy protocol postpartum, and breastfed following a timed lactation protocol.
Conclusion:
Management of lymphoma during pregnancy highlights the need to consider all aspects of proposed oncologic and obstetric care as well as neonatal risks. Considerations highlighted in this case include staging methods, administration of antenatal steroids, timing of delivery, and lactation during chemotherapy.
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