Lymphomas during pregnancy: diagnostic and therapeutic challenges

Abstract

Abstract. Introduction: Cancer during pregnancy is relatively rare, but hematologic malignancies such as lymphomas are among the more frequently encountered types. Managing cancer in pregnant patients presents a significant clinical challenge. Diagnosis is often complicated by the overlap between disease symptoms and physiological changes associated with pregnancy, as well as by limitations in imaging modalities and available treatment options. The study aim was to summarize current knowledge regarding the diagnosis and management of lymphoma during pregnancy. Materials and Methods: This study analyzed the medical records of pregnant patients diagnosed with lymphoma and treated at the Department of Hematology, University Hospital in Krakow, between 2011 and 2024. Results: Seven pregnant patients diagnosed with lymphoma were included in the analysis. The median age at the time of diagnosis was 27 years (range: 21-37). Five patients had Hodgkin lymphoma, while the remaining two were diagnosed with plasmablastic lymphoma and primary mediastinal B-cell lymphoma, respectively. The diagnosis was confirmed between the 5th and 30th week of pregnancy. Treatment strategies were tailored individually, taking into account the stage of pregnancy, disease severity, and the overall maternal condition. Only two patients underwent therapy during pregnancy, and no major complications were observed in these cases. Five women gave birth to healthy infants; the remaining two children were later diagnosed with health issues, including Duchenne muscular dystrophy and immune system disorders. One patient experienced a relapse and died six years after the initial diagnosis. Conclusion: Based on case analyses and a review of the literature, it was concluded that the best outcomes for both mother and newborn are achieved through a multidisciplinary approach, close monitoring, and appropriately tailored treatment strategies.