Hattori Daiki, Yahagi Yuichi, Uryu Hideki, Hosoba Rika, Momoki Mamiko, Nagao Riku, Yamazaki Hiroyuki
Department of Hematology, Kawaguchi Municipal Medical Center.
Department of Clinical Oncology and Hematology, The Jikei University School of Medicine.
Rinsho Ketsueki. 2019;60(2):112-117. doi: 10.11406/rinketsu.60.112.
At 11 weeks of pregnancy, a 31-year-old woman presented with an anterior chest tumor and dyspnea. A computed tomography (CT) scan revealed a bulky tumor in the mediastinum that compressed the trachea. She underwent a CT-guided needle biopsy and was diagnosed with primary mediastinal large B cell lymphoma. She was initially treated with steroid pulse therapy, followed by vincristine-cyclophosphamide-prednisolone (VCP) therapy, which relieved her dyspnea. She was then treated with 8 cycles of rituximab-cyclophosphamide-doxorubicin-vincristine-prednisolone (R-CHOP) therapy at 13 weeks of pregnancy. The patient delivered her baby at 35 weeks and 6 days of pregnancy. Despite the preterm delivery and other than the low-birth weight, her baby was healthy. A positron emission tomography-CT scan showed that a complete metabolic response was achieved. Our case report suggests that steroid pulse and VCP therapy followed by R-CHOP therapy is safe and effective for patients with malignant lymphoma in their first trimester of pregnancy.