Management of Hodgkin Lymphoma during pregnancy, review of the literature and description of an homogenous expectative attitude associated with excellent outcome

Crit Rev Oncol Hematol. 2024 Nov:203:104482. doi: 10.1016/j.critrevonc.2024.104482. Epub 2024 Aug 14.

Abstract

Hodgkin lymphoma (HL) occuring during pregnancy is a rare condition, and management relies on sparse literature. The specificity of pregnancy requires the clinician to take into account the clinical emergency, the stage of the lymphoma, the trimester of pregnancy, and the patient's choices. The main objective is twofold: to limit the risk of toxicity and adverse events for both mother and fetus, without reducing the chances of a successful outcome. Current literature data suggest that the use of ABVD-type polychemotherapy (adriamycin, bleomycin, vinblastine, dacarbazine) is associated with obstetrical events and long-term fetal toxicity. We report here the results of a homogeneous management considering wait-and-see, vinblastine monotherapy and ABVD polychemotherapy options. The outcomes in terms of obstetrical complications, response rate, and overall survival (100 %) reinforce the idea that strategies that do not involve the use of multidrug therapy are possible and are associated with very good results.

Keywords: Expectative attitude; Hodgkin Lymphoma; Polychemotherapy; Pregnancy; Vinblastine monotherapy.

Publication types

  • Review

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Bleomycin / administration & dosage
  • Bleomycin / adverse effects
  • Bleomycin / therapeutic use
  • Dacarbazine / administration & dosage
  • Dacarbazine / adverse effects
  • Dacarbazine / therapeutic use
  • Doxorubicin / administration & dosage
  • Doxorubicin / adverse effects
  • Doxorubicin / therapeutic use
  • Female
  • Hodgkin Disease* / drug therapy
  • Humans
  • Pregnancy
  • Pregnancy Complications, Neoplastic* / drug therapy
  • Pregnancy Outcome
  • Treatment Outcome
  • Vinblastine / administration & dosage
  • Vinblastine / adverse effects
  • Vinblastine / therapeutic use

Substances

  • Vinblastine
  • Dacarbazine
  • Bleomycin
  • Doxorubicin

Supplementary concepts

  • ABVD protocol