Most non-Hodgkin lymphomas (NHL) are aggressive and delay of therapy until after delivery appears to have poor outcomes according to anecdotal case series.[1,2,3,4] Consequently, some investigators favor immediate therapy, even during pregnancy.[4]

Children exposed to high-dose doxorubicin-containing combination chemotherapy in utero (especially during the second and third trimester) have been found to be normal subsequently, with follow-up ranging from several months to 11 years.[4,5,6,7] There are no data regarding long-term effects on children exposed in utero for most of the chemotherapeutic agents used for treatment of NHL.

Termination of pregnancy in the first trimester may be an option to allow therapy for women with aggressive NHL. For some women, early delivery when feasible may minimize or avoid exposure to chemotherapy or radiation therapy. Treatment may be delayed for those women with an indolent NHL.

The designations in PDQ that treatments are "standard" or "under clinical evaluation" are not to be used as a basis for reimbursement determinations.

References:

1. Ward FT, Weiss RB: Lymphoma and pregnancy. Semin Oncol 16 (5): 397-409, 1989.
2. Steiner-Salz D, Yahalom J, Samuelov A, et al.: Non-Hodgkin's lymphoma associated with pregnancy. A report of six cases, with a review of the literature. Cancer 56 (8): 2087-91, 1985.
3. Spitzer M, Citron M, Ilardi CF, et al.: Non-Hodgkin's lymphoma during pregnancy. Gynecol Oncol 43 (3): 309-12, 1991.
4. Gelb AB, van de Rijn M, Warnke RA, et al.: Pregnancy-associated lymphomas. A clinicopathologic study. Cancer 78 (2): 304-10, 1996.
5. Avilés A, Díaz-Maqueo JC, Torras V, et al.: Non-Hodgkin's lymphomas and pregnancy: presentation of 16 cases. Gynecol Oncol 37 (3): 335-7, 1990.
6. Moore DT, Taslimi MM: Multi-agent chemotherapy in a case of non-Hodgkin's lymphoma in second trimester of pregnancy. J Tenn Med Assoc 84 (9): 435-6, 1991.
7. Nantel S, Parboosingh J, Poon MC: Treatment of an aggressive non-Hodgkin's lymphoma during pregnancy with MACOP-B chemotherapy. Med Pediatr Oncol 18 (2): 143-5, 1990.