title: Reproductive organ involvement in non-Hodgkin lymphoma during pregnancy: a systematic review.
abstract: Data for pregnancy-associated non-Hodgkin lymphoma are limited to case reports, making it difficult to define this disorder. We did a systematic search for articles published between 1967 and 2011 with the aim to determine the characteristics, management, and outcome of pregnancy-associated non-Hodgkin lymphoma. We identified 121 patients from 74 papers. Most patients with stage information available presented with stage IV disease (75%, 82 of 108 patients). Patients were classified into three clinical groups; those with indolent lymphomas accounted for 5% (five of 108), aggressive lymphomas (diffuse large B-cell lymphoma and T-cell lymphomas) made up 48% of patients (52 of 108), and highly aggressive lymphomas (Burkitt's lymphoma, immunoblastic lymphoma, and unspecified highly aggressive lymphomas) accounted for 47% of patients (51 of 108). Reproductive organ involvement (breast, ovary, uterus, placenta) was reported in 49% of 110 patients with information available on extranodal involvement, and prevailed in endemic Burkitt's lymphoma (100%, 19 of 19), followed by non-endemic Burkitt lymphoma (70%, 14 of 20), immunoblastic lymphoma (67%, two of three), peripheral T-cell lymphoma (46%, six of 13), and indolent (40%, two of five) and diffuse large cell lymphoma (23%, nine of 40). Most patients received antepartum (45%, 55 of 121) or postpartum therapy (45%, 54 of 121), resulting in 6-month survival of 53% for mothers and a livebirth rate of 83%. Pregnancy-associated non-Hodgkin lymphoma has unique clinical characteristics with frequent reproductive organ involvement. Collaborative prospective studies are needed to further characterise pathophysiological and clinical aspects of this complication.
authors.affiliation: Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Netanel A
authors.initials: NA
authors.lastname: Horowitz
authors.forename: Noam
authors.initials: N
authors.lastname: Benyamini
authors.forename: Kristina
authors.initials: K
authors.lastname: Wohlfart
authors.forename: Benjamin
authors.initials: B
authors.lastname: Brenner
authors.forename: Irit
authors.initials: I
authors.lastname: Avivi
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000209:etiology*