A Review of Hematological Malignancy in Pregnancy

Abstract

Hematological malignancy in pregnancy is a rare condition which leads to lack of prospective study and randomized control trial. Nevertheless, it has own challenge to the medical field in term of managing patient with the said condition. The dilemma is to decide among the necessities of continuation of pregnancy, the choice of diagnostic tools and chemotherapeutic drugs, and the timing of initiation treatment without disregarding the women's wish and preferences. The process often has a profound psychological burden on patients and family members. Furthermore, delays in diagnosis and intervention will adversely affect the outcomes of pregnancy and the disease itself. The effect of teratogenicity of chemotherapeutic drugs on the fetus and the progression of the disease during pregnancy are the main concern in treating this group of patients. This article will review the management and outcomes of 6 cases of hematological malignancy in pregnancy in one center (3 Hodgkin lymphoma, 1 chronic myeloid leukemia, 1 hairy cell leukemia, and 1 myeloproliferative neoplasms).  The outcomes of the pregnancy cases in this article were five successful live births with one case of early neonatal death due to prematurity with a history of second-trimester loss. The treatment was initiated during the second trimester to reduce the risk of chemotherapy to the fetus. Even though a few cases had fetal growth compromise but the fetal outcomes seem to be good with early interventions and multidisciplinary approached.