Standard chemotherapy regimens can be successfully delivered to the majority of women diagnosed with lymphoma in pregnancy (LIP), according to Australian and New Zealand data representing one of the largest cohorts of LIP.
A retrospective study, published in the British Journal of Haematology [link here], reported on the features, management, and outcomes of lymphoma, diagnosed between 2009 and 2020 either during pregnancy or within the first 12 months following delivery at 16 sites in Australia and New Zealand.
The cohort comprised 73 patients, 41 diagnosed during pregnancy and 32 postnatally, with a median age of 32 years.
The study, from the Australasian Lymphoma Alliance, said the postnatal patients were included to capture lymphomas developing prior to delivery, but not diagnosed until afterwards “typically due to both the symptom obfuscation and diagnostic delays associated with pregnancy”.
The most common diagnoses were Hodgkin lymphoma (n=40), DLBCL (n=11), indolent B-cell non-Hodgkin lymphoma (n=7), and primary mediastinal B-cell lymphoma (n=6).
Collectively, LIP is the second most prevalent cancer diagnosed in pregnancy following breast cancer.
All but two patients received chemotherapy with or without rituximab and the majority (94%) received the full number of planned chemotherapy cycles.
About half (52%) also received granulocyte colony-stimulating factor support as either primary or secondary prophylaxis for febrile neutropenia.
The study said that 80% of the antenatal cohort received active treatment such as ABVD, R-CHOP or CHOP during pregnancy. Most patients had immediate treatment, four patients were deferred until later in their pregnancy, and seven patients deferred until the postnatal period.
The 2- and 5-year overall survival (OS) for all patients combined were 92% and 79% respectively, with no significant difference between the antenatal and postnatal groups.
“Seven patients died in the study period: three due to lymphoma, one due to complications of later allogeneic haematopoietic cell transplant and two due to infection, including one secondary to neutropenic sepsis during pregnancy.”