Hodgkin’s lymphoma during pregnancy – case report
Affiliation and adress for correspondence

1 Zakład Dydaktyki Ginekologiczno-Położniczej, Warszawski Uniwersytet Medyczny.
Kierownik Zakładu: prof. dr hab. n. med. Ewa Dmoch-Gajzlerska
2 Klinika Hematologii, Instytut Hematologii i Transfuzjologii w Warszawie.
Kierownik Kliniki: prof. nadzw. dr hab. n. med. Ewa Lech-Marańda
3 Klinika Zaburzeń Hemostazy i Chorób Wewnętrznych, Instytut Hematologii i Transfuzjologii w Warszawie.
Kierownik Kliniki: prof. dr hab. n. med. Jerzy Windyga
4 II Katedra i Klinika Położnictwa i Ginekologii, Warszawski Uniwersytet Medyczny.
Kierownik Katedry i Kliniki: prof. dr hab. n. med. Krzysztof Czajkowski
Correspondence to: Lek. med. Monika Chełstowska, Klinika Hematologii, Instytut Hematologii i Transfuzjologii, ul. Indiry Gandhi 14,
02-776 Warszawa, e-mail: mchelstowska@ihit.waw.pl
Source of financing: Department own sources

CURR. GYNECOL. ONCOL. 2014, 12 (1), p. 67–72
DOI: 10.15557/CGO.2014.0008
ABSTRACT

The incidence of hematologic malignancies in pregnancy ranges from 1:1000–1:10 000, with the most common lymphomas (1:1000–1:6000), Hodgkin’s lymphoma in particular. This paper describes a case of Hodgkin’s lymphoma diagnosed in a 36-year-old pregnant woman. The coexistence of pregnancy renders both the diagnosis and treatment more difficult. The signs of the disease may overlap with the symptoms associated with physiological pregnancy. The diagnosis is based on histopathological examination of the lesioned lymph node. The use of imaging techniques such as computed tomography and positron emission tomography should be avoided. Magnetic resonance and chest X-ray are acceptable; and there are no limitations for the use of ultrasound imaging. It is suggested that chemotherapy be delayed until the second trimester. The ABVD regimen is a standard treatment. In the case of disease progression, pregnancy termination and treatment outside pregnancy should be considered. In the case of pregnancy continuation, BEACOPP regimen may be used with optional, complementary radiotherapy. Treatment results for Hodgkin’s lymphoma diagnosed during pregnancy do not seem worse compared with age-matched groups. The management of pregnant patients with hematologic cancer requires care provided by a multidisciplinary team. Therapeutic decisions must account for the wellbeing of both, the mother and the fetus. The birth should be scheduled between courses so as to avoid pancytopenia in the patient and the newborn. The incidence of hematologic malignancies during pregnancy is rare, therefore it seems reasonable to collect data in the international registry in order to allow for an objective assessment of epidemiology, risk factors and treatment options.

Keywords: hematologic malignancies, Hodgkin’s lymphoma, pregnancy, chemotherapy, treatment