On Sandy, Chang Abraham
Department of Pharmacy, Stanford Health Care, Palo Alto, CA, USA.
Leuk Lymphoma. 2022 Dec;63(12):2897-2904. doi: 10.1080/10428194.2022.2100368. Epub 2022 Jul 20.
Safety of chemoimmunotherapy during pregnancy for treatment of Non-Hodgkin's lymphoma (NHL) is controversial. We review 37 cases of mothers with high grade NHL treated with rituximab and concurrent chemotherapy during pregnancy. Majority (95%) of mothers were treated in their second and third trimester, and a median of 4 cycles of combination therapy was administered. Complete remission occurred in 14/17 (82%) mothers whose disease outcomes were reported. There were 2 spontaneous abortions and 1 trimester fetal death that occurred in 3 mothers who received treatment in their first and second trimesters. Among the 34 (92%) live births, there were 6 cases of respiratory/cardiac complications requiring intervention and 5 cases of hematologic abnormalities reported. This review highlights the efficacy and safety of chemoimmunotherapy for mothers treated in second and third trimester. Further data is needed to establish recommendations for management of mothers with aggressive NHL in their first trimester of pregnancy.
孕期进行化疗免疫疗法治疗非霍奇金淋巴瘤（NHL）的安全性存在争议。我们回顾了37例孕期接受利妥昔单抗及同步化疗的高级别NHL母亲病例。大多数（95%）母亲在孕中期和孕晚期接受治疗，联合治疗的中位疗程数为4个周期。在报告疾病转归的17例母亲中，14例（82%）实现完全缓解。在孕早期和孕中期接受治疗的3例母亲中，发生了2例自然流产和1例孕早期胎儿死亡。在34例（92%）活产儿中，报告有6例需要干预的呼吸/心脏并发症以及5例血液学异常。本综述强调了化疗免疫疗法对孕中期和孕晚期母亲的疗效及安全性。需要更多数据来制定针对孕早期患有侵袭性NHL母亲的管理建议。
