Sydney Adventist Hospital, Wahroonga, New South Wales, Australia.
College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.
Br J Haematol. 2023 Jun;201(5):887-896. doi: 10.1111/bjh.18727. Epub 2023 Mar 7.
Lymphoma in pregnancy (LIP) presents unique clinical, social and ethical challenges; however, the evidence regarding this clinical scenario is limited. We conducted a multicentre retrospective observational study reporting on the features, management, and outcomes of LIP in patients diagnosed between January 2009 and December 2020 at 16 sites in Australia and New Zealand for the first time. We included diagnoses occurring either during pregnancy or within the first 12 months following delivery. A total of 73 patients were included, 41 diagnosed antenatally (AN cohort) and 32 postnatally (PN cohort). The most common diagnoses were Hodgkin lymphoma (HL; 40 patients), diffuse large B-cell lymphoma (DLBCL; 11) and primary mediastinal B-cell lymphoma (PMBCL; six). At a median follow up of 2.37 years, the 2- and 5-year overall survival (OS) for patients with HL were 91% and 82%. For the combined DLBCL and PMBCL group, the 2-year OS was 92%. Standard curative chemotherapy regimens were successfully delivered to 64% of women in the AN cohort; however, counselling regarding future fertility and termination of pregnancy were suboptimal, and a standardised approach to staging lacking. Neonatal outcomes were generally favourable. We present a large multicentre cohort of LIP reflecting contemporary practice and identify areas in need of ongoing research.
妊娠合并淋巴瘤（LIP）呈现出独特的临床、社会和伦理挑战；然而，关于这一临床情况的证据有限。我们首次在澳大利亚和新西兰的 16 个地点进行了一项多中心回顾性观察研究，报告了 2009 年 1 月至 2020 年 12 月期间诊断出的 LIP 患者的特征、管理和结局。我们纳入了在妊娠期间或分娩后 12 个月内诊断出的病例。共纳入了 73 例患者，其中 41 例在产前（AN 队列）诊断，32 例在产后（PN 队列）诊断。最常见的诊断是霍奇金淋巴瘤（HL；40 例）、弥漫性大 B 细胞淋巴瘤（DLBCL；11 例）和原发性纵隔 B 细胞淋巴瘤（PMBCL；6 例）。在中位随访 2.37 年后，HL 患者的 2 年和 5 年总生存率（OS）分别为 91%和 82%。对于合并的 DLBCL 和 PMBCL 组，2 年 OS 为 92%。在 AN 队列中，64%的女性成功接受了标准的治愈性化疗方案；然而，关于未来生育能力和终止妊娠的咨询并不理想，且缺乏标准化的分期方法。新生儿结局通常较好。我们呈现了一个大型的多中心 LIP 队列，反映了当代实践，并确定了需要持续研究的领域。
