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Pregnancy‐associated lymphomas: A clinicopathologic study
Author(s) -
Gelb Arnold B.,
van de Rijn Matthijs,
Warnke Roger A.,
Kamel Onsi W.
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960715)78:2<304::aid-cncr18>3.0.co;2-#
Subject(s) - medicine , nodular sclerosis , pregnancy , gestation , lymphoma , disease , stage (stratigraphy) , gastroenterology , pathology , hodgkin lymphoma , paleontology , biology , genetics
BACKGROUND The natural histories of Hodgkin's disease (HD) and non‐Hodgkin's lymphomas (NHL) during pregnancy are not well understood. METHODS All cases of HD and NHL diagnosed during pregnancy at Stanford University Medical Center since 1987 were reviewed and clinical follow‐up was obtained. Various immunohistochemical studies and in situ hybridization for Epstein–Barr virus (EBV) encoded RNA were performed in a subset of cases. RESULTS Seventeen cases of HD and 12 cases of NHL were accessioned (median age; 27 yrs). The HD cases were classified as 13 nodular sclerosis type, 3 mixed cellularity type, and 1 unclassified. Clinical follow‐up revealed most of the patients had Stage II to III disease and were diagnosed on average at 22 weeks gestation. Most of the patients deferred therapy until after delivery and had no evidence of disease at the last follow‐up except for one death with disease but not from it. NHL were classified according to the working formulation as high or intermediate grade lymphomas of various types, including both nodal and extranodal sites. Clinical follow‐up revealed most had Stage II to IV disease and were diagnosed on average at 23 weeks gestation. Patients with HD tended to survive longer than those with NHL (raw mortality, P = 0.04). In situ hybridization failed to provide support for the presence of EBV in a subset of patients with NHL. CONCLUSIONS The clinical behavior of these neoplasms during pregnancy does not appear to be significantly different from that outside of the setting of pregnancy. Treatment of selected HD patients apparently may be safely deferred until after delivery. Patients with NHL present with higher stage disease and have a poorer prognosis than those with HD. Cancer 1996;78:304‐10.