Cytotoxic therapy and pregnancy

Ebert, Ulrike; Löffler, Helmut; Kirch, W.

doi:10.1016/s0163-7258(97)82004-9

Cited by 177 publications

(133 citation statements)

References 31 publications

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“…Although all chemotherapy agents used in the treatment of breast cancer in pregnancy are Category D (ie, teratogenic effects have occurred in people), a surprising safety profile has been demonstrated if administered outside of the first trimester [4,7,11,[56][57][58][59][60][61][62]. Most frequently documented complications included preterm delivery, low birth weight, transient leukopenia of the newborn, and intrauterine growth restriction.…”

Section: Systemic Therapymentioning

confidence: 99%

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Pregnancy-Associated Breast Cancer: A Literature Review

Barnes

Newman

2007

Surgical Clinics of North America

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Breast cancer, along with cervical cancer, is one of the most commonly diagnosed cancers of pregnancy. Most would define gestational breast cancer as breast cancer that is diagnosed during pregnancy, lactation, and up to 12 months post-partum. The diagnostic and therapeutic implications in this clinical setting are special. These women typically present with a more advanced-stage disease that carries an associated poorer prognosis. Physicians thus are challenged to balance aggressive maternal care with appropriate modifications that will ensure fetal protection. . Of women diagnosed with breast cancer younger than 40 years, only approximately 10% will be pregnant [2,3]. These data certainly suggest a low incidence of pregnancy-associated breast cancer. In fact, historically, the incidence is estimated at 1 in 3000 pregnancies [4][5][6]. Despite the overall low incidence, however, gestational breast cancer is one of the most common pregnancy-associated malignancies, second only to cervical cancer [4,6]. Notably, many have offered that this incidence will only increase as more women delay childbearing until later in life [4,7]. This concern is based on the fact that pregnancy-associated breast cancer is age-related, and women

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Section: Systemic Therapymentioning

confidence: 99%

“…Methotrexate is a known abortifacient, and it should be avoided during pregnancy [7,58]. There are several case reports that support the safety of taxanes in treating pregnancy-associated breast cancer, but nothing to support the safety of dose dense anthracycline therapy with or without taxanes during pregnancy [69][70][71][72][73].…”

Section: Systemic Therapymentioning

confidence: 99%

Pregnancy-Associated Breast Cancer: A Literature Review

Barnes

Newman

2007

Surgical Clinics of North America

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“…All delivered normal infants that remained healthy. 5 Multiagent therapy using COPP, 6 MOPP, 7 or MPP with vinblastine 8 in second and third trimesters was associated with favorable outcomes for pregnant patients and infants. One series examined the outcomes of 9 newly diagnosed and 8 relapsed pregnant HL patients (Stages IA-IIA: 16, Stage IIIA: 1); 7 were treated with supradiaphragmatic radiation during 10 to 30 weeks of gestation, 2 underwent therapeutic abortion, and 6 deferred therapy until after delivery.…”

Section: A 26-year-old Woman Who Is 22 Weeks Into Her First Pregnancymentioning

confidence: 99%

How Is Hodgkin Lymphoma in Pregnancy Best Treated?

Bachanová¹,

Connors²

2008

Hematology

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“…Methotrexate (a folate antagonist), a crucial component of most intensification protocols of ALL, is highly teratogenic and abortifacient when administered during the first trimester. Also the exposure to high dose methotrexate after the 1st trimester was associated with cranial dysostosis, delayed ossification, hypertelorism, wide nasal bridge, micrognatia, anomalies of external ears and cleft palate (aminopterin syndrome) (Ebert et al, 1997). The risk of fetal malformations diminishes as pregnancy advances (Ebert et al, 1997).…”

Section: Acute Lymphoblastic Leukemia (All)mentioning

confidence: 99%

“…Also the exposure to high dose methotrexate after the 1st trimester was associated with cranial dysostosis, delayed ossification, hypertelorism, wide nasal bridge, micrognatia, anomalies of external ears and cleft palate (aminopterin syndrome) (Ebert et al, 1997). The risk of fetal malformations diminishes as pregnancy advances (Ebert et al, 1997). Thereafter, termination of pregnancy is recommended for patients prior to the 20th week of gestation followed by the standard intensification chemotherapeutic ALL protocol.…”

Section: Acute Lymphoblastic Leukemia (All)mentioning

confidence: 99%