Use of Rituximab in NHL Malt Type Pregnant in I° Trimester for Two Times.

Antonello Sica,Armando Calogero,Fortunato Ciardiello,Danilo Casale,Erika Martinelli,Concetta Anna Dodaro,Gino Svanera,Maria Mottola,Beniamino Casale,Caterina Sagnelli,Teresa Troiani,Paola Vitiello,Alfonso Papa

doi:10.1515/med-2019-0087

Abstract

Administration of rituximab, one of the basic drugs for the therapy of B-cell lymphoproliferative diseases, during pregnancy has been suspected to cause developmental fetal events, particularly if given during the first trimester of pregnancy. Therefore, use in pregnancy is not permitted. Howe ver, several cases of pregnant women being treated with rituximab are reported herein; an exception is often made in cases with grave illness.We describe an exceptional case of a woman with non-Hodgkin lymphoma of the mucosa-associated lymphoid tissue type where rituximab was given as a single agent without interruption during two consecutive pregnancies. This case can certainly supply important indications on the safety of rituximab.

Highlights

Based on human data, rituximab alleged to cause adverse fetal development: B-cell lymphocytopenia is observed in fetuses exposed to rituximab in utero [1]
Rituximab is commonly used in systemic and primitive cutaneous B-cell lymphoproliferative diseases, alone or in combination with other chemotherapy based on the type of lymphoma [3]
We report the first clinical case of women in whom the use of rituximab was given in two consecutive pregnancies in early months of pregnancy

Summary

Introduction

Rituximab alleged to cause adverse fetal development: B-cell lymphocytopenia is observed in fetuses exposed to rituximab in utero [1]. Pregnant women must be informed of the risk to the fetus and those of potential childbearing age must use effective contraception during treatment with rituximab and for 12 months after the last dose of rituximab. In pregnant women who received rituximab, the newborn infant must be observed for signs of infection [2]. Rituximab is commonly used in systemic and primitive cutaneous B-cell lymphoproliferative diseases, alone or in combination with other chemotherapy based on the type of lymphoma [3]. In pregnant cynomolgus monkeys the use of rituximab during fetal organogenesis caused lymphoid B-cell depletion in the newborn. We report the first clinical case of women in whom the use of rituximab was given in two consecutive pregnancies in early months of pregnancy

Case report

Findings

Discussion

Conclusion