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General Updates | Managing Hodgkin and non-Hodgkin lymphoma during pregnancy
In this video, Daan Dierickx, MD, PhD, KU Leuven and University Hospitals Leuven, Leuven, Belgium, discusses the management of Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (NHL) during pregnancy. In HL, chemotherapy can be safely administered from the second trimester onwards, while radiotherapy is typically delayed until after pregnancy, and certain novel immunotherapies, such as brentuximab vedotin, are avoided due to potential risks. Prof. Dierickx highlights that rituximab combined with CHOP chemotherapy can be given from the second trimester in patients with NHL, although rituximab treatment may cause transient cytopenia in the newborn. This interview took place virtually.
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Transcript
For Hodgkin lymphoma, actually, if it’s in the first trimester, most patients can wait until the second trimester. So that’s not very problematic. And from the second trimester on, we actually can treat the patients with the classical chemotherapy that we also give in non-pregnant patients. So it means that you can give it safely. There is a long follow-up for the mother, but also for the child till 18 to 20 years old, where you see no problems regarding physical or psychological or cognitive development...
For Hodgkin lymphoma, actually, if it’s in the first trimester, most patients can wait until the second trimester. So that’s not very problematic. And from the second trimester on, we actually can treat the patients with the classical chemotherapy that we also give in non-pregnant patients. So it means that you can give it safely. There is a long follow-up for the mother, but also for the child till 18 to 20 years old, where you see no problems regarding physical or psychological or cognitive development. So for Hodgkin lymphoma, the classical chemotherapy can be given. If it’s a combined modality treatment with chemotherapy and radiotherapy, we give the chemotherapy mostly during the pregnancy and the radiotherapy afterwards, because radiotherapy is actually not recommended to be given during the pregnancy. For the new immune therapies, we have to be careful. So the brentuximab vedotin, which is now reimbursed for stage four, cannot be given during pregnancy. Whereas, as I already told, the checkpoint inhibition can be given, but we should be careful for autoimmune disorders, both in the mother, but also in the baby afterwards.
For aggressive non-Hodgkin lymphoma, the most classical therapy is rituximab combined with CHOP chemotherapy. And this can also be given, the CHOP chemotherapy from the second trimester on; rituximab can be given throughout the pregnancy. But you sometimes see some cytopenia in the newborn, but it’s mostly transient and not leading to serious infections.
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