Pregnancy Does Not Increase Risk for Hodgkin Lymphoma Relapse

Summary and Comment |
February 9, 2016

Pregnancy Does Not Increase Risk for Hodgkin Lymphoma Relapse

  1. Michael E. Williams, MD, ScM

Only 2% of relapses occurred following a pregnancy among women in remission after induction chemotherapy.

  1. Michael E. Williams, MD, ScM

The risk for relapse among women who become pregnant while in remission from Hodgkin lymphoma (HL) after initial chemotherapy has been unclear. To resolve this issue, investigators studied all women in the Swedish Cancer Registry between 1992 and 2009 who were 18 to 40 years of age at initial HL diagnosis and in complete remission more than 6 months after diagnosis.

Patients received MOPP-ABVD (mechlorethamine, vincristine, procarbazine, prednisone, adriamycin, bleomycin, vinblastine, and dacarbazine) until 1998, after which they received ABVD or, in some high-risk cases, BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone). Pregnancy data was obtained from the Swedish Medical Birth Registry, which included stillbirths after 22 to 28 weeks of gestation.

Of the 449 women who met the study criteria, 144 (32%) had at least one pregnancy during follow-up (until relapse, death, or the end of 2010). Pregnancy rates did not differ significantly after the three chemotherapy regimens. A total of 47 relapses occurred, of which only 1 (2%) followed a recent pregnancy. The relapse rate peaked during the first year after diagnosis, whereas pregnancies occurred most often 2 to 5 years after diagnosis.

Comment

Concern about relapse after pregnancy is common among young women with HL. However, counseling patients about this issue has been difficult for oncologists due to the lack of robust data. This reassuring study found no evidence that becoming pregnant while in remission from HL increases the risk for relapse. Thus, concern about pregnancy-associated relapse does not need to influence postremission family planning.

Editor Disclosures at Time of Publication

  • Disclosures for Michael E. Williams, MD, ScM at time of publication Consultant / Advisory board Celgene; Takeda; TG Therapeutics; Bristol-Myers Squibb Speaker's bureau Research to Practice Grant / Research support Celgene; Janssen; Allos; Pharmacyclics; Gilead

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