Michael Lishner, Meir Medical Center, Kfar Saba, and Tel Aviv University; Irit Avivi, Ichilov Medical Center, Tel Aviv, Israel; Jane F. Apperley, Hammersmith Hospital; Susan Robinson, Guy's and St Thomas' National Health Service Foundation Trust, London; Frank Van den Heuvel, University of Oxford, Oxford, United Kingdom; Andrew M. Evens, Tufts Medical Center, Boston, MA; Monica Fumagalli, University of Milan; Fedro Alessandro Peccatori, European Institute of Oncology, Milan, Italy; Irena Nulman, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; Fuat S. Oduncu, University of Munich, Munich, Germany; Kristel Van Calsteren, University Hospital Gasthuisberg; Tineke Vandenbroucke and Frederic Amant, Katholieke Universiteit Leuven; Daan Dierickx, University of Leuven; and Tineke Vandenbroucke, University Hospitals Leuven, Leuven, Belgium.
J Clin Oncol. 2016 Feb 10;34(5):501-8. doi: 10.1200/JCO.2015.62.4445. Epub 2015 Nov 30.
The incidence of hematologic malignancies during pregnancy is 0.02%. However, this figure is increasing, as women delay conception until a later age. Systemic symptoms attributed to the development of a hematologic cancer may overlap with physiologic changes of pregnancy. A favorable prognosis is contingent upon early diagnosis and treatment. Therefore, a high index of suspicion is required by health care providers. Although timely, accurate diagnosis followed by appropriate staging is essential and should not be delayed due to pregnancy, management guidelines are lacking due to insufficient evidence-based research. Consequently, treatment is delayed, posing significant risks to maternal and fetal health, and potential pregnancy termination. This report provides guidelines for clinical management of hematologic cancers during the perinatal period, which were developed by a multidisciplinary team including an experienced hematologist/oncologist, a high-risk obstetrics specialist, a neonatologist, and experienced nurses, social workers, and psychologists.
These guidelines were developed by experts in the field during the first International Consensus Meeting of Prenatal Hematologic Malignancies, which took place in Leuven, Belgium, on May 23, 2014.
This consensus summary equips health care professionals with novel diagnostic and treatment methodologies that aim for optimal treatment of the mother, while protecting fetal and pediatric health.
怀孕期间血液系统恶性肿瘤的发病率为 0.02%。然而，由于女性延迟受孕年龄，这一数字正在增加。归因于血液系统癌症发展的全身症状可能与妊娠的生理变化重叠。良好的预后取决于早期诊断和治疗。因此，医疗保健提供者需要高度怀疑。尽管及时、准确的诊断后进行适当的分期至关重要，不应因妊娠而延迟，但由于缺乏基于证据的研究，缺乏管理指南。因此，治疗被延迟，对母婴健康和潜在妊娠终止构成重大风险。本报告提供了围产期血液系统恶性肿瘤临床管理指南，该指南由包括经验丰富的血液科医生/肿瘤学家、高危产科专家、新生儿科医生以及经验丰富的护士、社会工作者和心理学家在内的多学科团队制定。
这些指南是由 2014 年 5 月 23 日在比利时鲁汶举行的第一次产前血液恶性肿瘤国际共识会议上的该领域专家制定的。
本共识摘要为医疗保健专业人员提供了新颖的诊断和治疗方法，旨在优化母亲的治疗，同时保护胎儿和儿科健康。
