孕期霍奇金淋巴瘤的管理：文献综述及一致的预期态度与优异疗效的描述
Management of Hodgkin Lymphoma during pregnancy, review of the literature and description of an homogenous expectative attitude associated with excellent outcome
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影响因子:5.6
分区:医学2区 Top / 血液学2区 肿瘤学2区
发表日期:2024 Nov
作者:
Joshua Hagège, Lorea Aguinaga, Hannah Moatti, Roberta Di Blasi, Catherine Thieblemont, Pauline Brice, Loïc Renaud
DOI:
10.1016/j.critrevonc.2024.104482
摘要
孕期出现霍奇金淋巴瘤（HL）是一种罕见情况，其管理依赖于有限的文献资料。孕期特有的情况要求临床医生在考虑临床紧急情况、淋巴瘤分期、孕期阶段及患者意愿的基础上制定治疗方案。主要目标是两方面：既要降低母体和胎儿的毒性和不良事件风险，又不能降低治疗成功的几率。现有文献数据表明，使用ABVD方案（阿霉素、博莱霉素、长春新碱、多柔比星）化疗与产科事件和长期胎儿毒性相关。本文报道一种统一的管理方案，考虑等待观察、长春新碱单药治疗和ABVD多药化疗的选择。产科并发症、应答率及总生存率（100%）的结果支持不使用多药联合治疗的策略是可行的，并且效果非常理想。
Abstract
Hodgkin lymphoma (HL) occuring during pregnancy is a rare condition, and management relies on sparse literature. The specificity of pregnancy requires the clinician to take into account the clinical emergency, the stage of the lymphoma, the trimester of pregnancy, and the patient's choices. The main objective is twofold: to limit the risk of toxicity and adverse events for both mother and fetus, without reducing the chances of a successful outcome. Current literature data suggest that the use of ABVD-type polychemotherapy (adriamycin, bleomycin, vinblastine, dacarbazine) is associated with obstetrical events and long-term fetal toxicity. We report here the results of a homogeneous management considering wait-and-see, vinblastine monotherapy and ABVD polychemotherapy options. The outcomes in terms of obstetrical complications, response rate, and overall survival (100 %) reinforce the idea that strategies that do not involve the use of multidrug therapy are possible and are associated with very good results.