ABCL-263 Our Experience in the Management of Patients With Lymphoma During Pregnancy

Abstract

Hodgkin and Non-Hodgkin lymphomas (HL and NHL) associated with childbearing pose extremely difficult questions for the patient and her physician. The aim of the current study was a comprehensive analysis of our experience in the management of patients with HL and NHL during pregnancy in Armenia during the last 10 years. The main data source for this study was clinical data from the Register of Blood Diseases of the Hematology Center after R. Yeolyan. Diagnosis of HL and NHL as well as the definition of the stage were carried out according to the generally accepted international criteria. During this period, we had cases with HL and 4 with NHL associated with pregnancy. The median age for HL was 28.2±0.2 (range 26-30) and for NHL - 23.8±0.3 years (range 23-25). Their first visit to a hematologist for HL and NHL was at the stage of 32-34 and 22-23 weeks of pregnancy respectively. According to the literature data and the results of our study, the frequency of the subtype, stages, and prognosis in patients with HL is the same in both pregnant and non-pregnant cohorts. Among them, there were both patients with the first pregnancy and patients with the second and third pregnancies. They were mostly diagnosed with stage 2 or 3 HL, with nodular sclerosis, involving the cervical, axillary, and mediastinal lymph nodes. Patients with HL were closely monitored by a hematologist-oncologist until delivery, after delivery they began treatment under the BEACOPP program. All patients and their children are currently alive. All cases of NHL were DLBCL, with an aggressive course of the disease. The issue of therapy for patients with NHL was decided individually, depending on the patient's condition, and the stage of the disease. Basically, it was a course of CHOP or R-CHOP, then childbirth, after that few more courses. Three patients and their children are currently alive. We have only one deadly case and one mother after delivery refused treatment. Only well-coordinated teamwork of hematologist-oncologists, obstetrician-gynecologist with an element of the patient's choice can lead to saving the life of the mother and normal delivery.