Luttwak E, Gurevich-Shapiro A, Azem F, Lishner M, Klieger C, Herishanu Y, Perry C, Avivi I
Division of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Division of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Immunology, Weizmann Institute of Science, Rehovot, Israel.
Blood Rev. 2021 Sep;49:100831. doi: 10.1016/j.blre.2021.100831. Epub 2021 Apr 16.
Lymphoproliferative diseases occurring during pregnancy present unique diagnostic and therapeutic challenges aiming to achieve maternal cure without impairing fetal health, growth, and survival. These goals are further complicated by the fast-paced emergence of novel therapies and their introduction as standard of care, even in newly diagnosed patients. Due to the rarity of hematological malignancies in pregnancy and the exclusion of pregnancy in almost all clinical trials, available data on the fetal effects of novel drugs are limited to animal models and case reports. The current review addresses the entire multidisciplinary team involved in treating pregnant patients with lymphoproliferative diseases. We describe novel agents according to their mechanism of action, and summarize our knowledge of their effects during the gestational period, particularly those associated with fetotoxicity. Therapeutic dilemmas associated with the employment of these new agents are also discussed.
孕期发生的淋巴增殖性疾病带来了独特的诊断和治疗挑战，旨在实现母体治愈的同时不损害胎儿健康、生长和存活。新型疗法的快速出现及其作为标准治疗方法的引入，即使在新诊断的患者中，也使这些目标变得更加复杂。由于孕期血液系统恶性肿瘤罕见，且几乎所有临床试验都排除了孕妇，关于新型药物对胎儿影响的现有数据仅限于动物模型和病例报告。本综述涉及参与治疗患有淋巴增殖性疾病孕妇的整个多学科团队。我们根据新型药物的作用机制进行描述，并总结我们对其在妊娠期影响的了解，特别是那些与胎儿毒性相关的影响。还讨论了使用这些新型药物相关的治疗困境。
