Successful Management of Primary Mediastinal Large B-cell Lymphoma during Pregnancy

Abstract

We experienced a pregnant woman with superior vena cava syndrome at 15 weeks of pregnancy who was diagnosed with primary mediastinal large B-cell lymphoma and given chemotherapy. In this case, the clinical courses of both the mother and infant were favorable without any serious complications because of close multidisciplinary cooperation. Based on a retrospective review of this case, the administration of CHOP-like regimens during the second and third trimesters appears relatively safe. Because pregnancy and continuation of pregnancy are rare in patients with hematopoietic malignancies, the accumulation of detailed information is important.

Cancer during Pregnancy: A Review of Preclinical and Clinical Transplacental Transfer of Anticancer Agents

“…One study on the pharmacokinetics of doxorubicin in pregnant women indicated a decreased clearance of doxorubicin during pregnancy [ 122 ]. According to several case reports, the use of doxorubicin appears relatively safe during pregnancy [ 105 , 123 , 124 , 125 , 126 ]. In contrast, a case of intrauterine death after exposure to epirubicin for breast cancer has been reported [ 127 ].…”

Treatment of primary mediastinal B-cell lymphoma with dose-adjusted REPOCH during pregnancy

“…7 There are reports of patients with PMBCL treated with R-CHOP during pregnancy and then transitioning to DA-REPOCH postpartum. 8 This was done due to the concern that etoposide would cause fetal cranial abnormalities and skeletal malformations. However, etoposide exposure during the second and third trimesters did not seem to cause any congenital malformations.…”