title: Multiple myeloma and pregnancy: a case report and literature review.
abstract: OBJECTIVE
  Multiple myeloma, a hematological malignancy generally affecting elderly people, was diagnosed at the beginning of the pregnancy of a 33-year-old woman. We carried out a literature review in order to evaluate the consequences of this cancer on pregnancy and of pregnancy on multiple myeloma, as to determine the specific follow-up required.
  
  
  METHODS
  A systematic search for articles of interest published between 1949 and 16 November 2010 was performed in MEDLINE, SCOPUS and EMBASE, using the words "multiple myeloma" and "pregnancy". We identified 398 publications of potential interest, 20 of which were selected and included in the analysis.
  
  
  RESULTS
  The selected articles included 26 cases. No specific risk factors were identified in pregnant women. The most common presentations were bone pain and/or anemia, as in the general population. Pregnancy seemed to have no effect on multiple myeloma progression. Most pregnancies went to term, with only two medical terminations and six cesareans performed before term, due to the severity of the cancer. No effect of the cancer or its treatment by chemotherapy during pregnancy was found in the children.
  
  
  CONCLUSIONS
  Pregnancy does not seem to be contraindicated in women with multiple myeloma. Nevertheless, the management of pregnant patients with multiple myeloma is a diagnostic, therapeutic and social challenge, requiring a multidisciplinary approach and regular follow-up. Decisions should be taken based on the severity of the disease, its prognosis and maternal choice.
authors.affiliation: Department of Obstetrics and Gynecology, Pointe-à-Pitre/Abymes University Hospital, BP 465, 97159 Pointe à Pitre Cedex, Guadeloupe, France. phnou@free.fr
authors.forename: Daphné
authors.initials: D
authors.lastname: Borja de Mozota
authors.forename: Philippe
authors.initials: P
authors.lastname: Kadhel
authors.forename: Slimane
authors.initials: S
authors.lastname: Dermeche
authors.forename: Luc
authors.initials: L
authors.lastname: Multigner
authors.forename: Eustase
authors.initials: E
authors.lastname: Janky
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000473:pathology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000473:pathology; D011261:Pregnancy Trimester, First; D011295:Prenatal Care; D011296:Prenatal Diagnosis