Hematology and Bone Marrow Transplant Unit, Tel Aviv Medical Center, Tel Aviv, Israel.
Drugs. 2015 Oct;75(15):1725-38. doi: 10.1007/s40265-015-0464-0.
The diagnosis and management of hematologic malignancy during pregnancy is a significant challenge. This is due to both medical and ethical considerations regarding when and how to treat this special sub-group of patients. Recurring uncertainties remain around appropriate imaging techniques, timing and dosage of chemotherapy, and timing of delivery. In this article we examine and summarize current literature in this field to assist physicians in their understanding and management of this patient group. Special attention has been given to diagnostic and staging procedures, risks associated with chemotherapy at different stages of gestation, and chemotherapy-dose adaption during pregnancy. In addition, recommended guidelines for management of lymphoma, leukemia, and planning delivery are discussed. A multidisciplinary team approach is critical for patient care, as is shared decision making with the patient and family.
妊娠期血液恶性肿瘤的诊断和管理是一项重大挑战。这是由于在何时以及如何治疗这一特殊亚组患者方面存在医学和伦理方面的考虑。在适当的影像学技术、化疗的时间和剂量以及分娩时间方面仍然存在反复出现的不确定性。本文通过检查和总结该领域的现有文献，以帮助医生了解和管理这一患者群体。特别关注了诊断和分期程序、不同妊娠阶段化疗相关的风险，以及妊娠期化疗剂量调整。此外，还讨论了淋巴瘤、白血病的治疗建议和分娩计划。患者护理需要多学科团队方法，与患者和家属共同决策也很关键。
