Combination chemotherapy for Hodgkin's lymphoma during pregnancy: favorable outcome for mother and child.
The incidence of malignant neoplasms in pregnant women is rising dramatically. The management of such cases poses unusual medical and ethical challenges, particularly in hematological malignancies, when potentially teratogenic chemotherapy is indicated. We report a case of stage IIA nodular sclerosis Hodgkin's lymphoma (HL), diagnosed in a 24-year-old woman at 18 weeks of gestation. Individualized combination chemotherapy according to etoposide-vinblastine-doxorubicin (EVA) regimen was administered, resulting in effective local control of the disease and improvement in the patient's general condition. At the 36th week of pregnancy, the patient delivered a healthy female infant by elective cesarian section. Four weeks later, bleomycin-dacarbazine-doxorubicin-vinblastine (ABVD) chemotherapy was commenced, which provided complete remission after five cycles. Individualized chemotherapy for HL according to EVA regimen during the second and third trimesters of pregnancy, with early cesarian delivery, followed by ABVD regimen, provided a positive outcome both for the mother and her child. This strategy may be considered as an alternative for the treatment of HL in pregnancy, and deserves further clinical assessment.
Sagan
Dariusz
D
Department of Thoracic Surgery, Medical University of Lublin, Lublin, Poland. dariusz.sagan@am.lublin.pl
Semczuk
Andrzej
A
Lampka
Elzbieta
E
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D001761:Bleomycin; D003606:Dacarbazine; D018572:Disease-Free Survival; D004317:Doxorubicin; D005047:Etoposide; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*; D016896:Treatment Outcome; D014747:Vinblastine
D001761:Bleomycin; D014747:Vinblastine; D005047:Etoposide; D003606:Dacarbazine; D004317:Doxorubicin