Document Detail


Hematological malignancies and pregnancy: treat or no treat during first trimester.
MedLine Citation:
PMID:  22511239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Treatment of hematological malignancies (HM) during pregnancy remain unsolved, although the use of chemotherapy during second and third trimester has been accepted because of the low rate of toxicities, the use of cytotoxic drugs during first trimester is generally forbidden. Most of the concerns are related to congenital abnormalities and development, but long-term follow-up of these children are not available. From 1975 to 2008, we diagnosed and treated 15,750 cases of HM, and 143 female patients were pregnant during this time that were treated with combined chemotherapy. In our study, we present the long-term follow-up (the median follow-up was 22.4 years with a range of 3.8-32.0 years) of 54 newborns, whose mothers received chemotherapy during the first trimester of pregnancy with an intent-to-cure HM. Physical and neurological development were carefully assessed, and cardiac and chromosomal studies were performed until the age of 20 years to evaluate late toxicities. The obstetrical development of pregnancy was normal, chemotherapy was used at doses and schedules used in normal patients. Low-weight birth was the most frequent finding. No congenital abnormalities were detected. Physical, psychological and neurological developments were normal. Education and academic degree were according to the economical and social factors. Cardiac function and chromosomal examination were normal. No neoplasm or acute leukemia has been observed in these children. Forty-three mothers are alive and disease-free and can be considered cured. The use of cytotoxic drugs during the first trimester to treat HM seems to be beneficial to both the mother and fetus, and chemotherapy during the first trimester can be considered if the cure of the patient is the goal.
Authors:
Agustin Avilés; Natividad Neri; María-Jesús Nambo
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Publication Detail:
Type:  Journal Article     Date:  2012-04-18
Journal Detail:
Title:  International journal of cancer. Journal international du cancer     Volume:  131     ISSN:  1097-0215     ISO Abbreviation:  Int. J. Cancer     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-09-26     Completed Date:  2013-03-08     Revised Date:  2013-03-11    
Medline Journal Info:
Nlm Unique ID:  0042124     Medline TA:  Int J Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2678-83     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 UICC.
Affiliation:
Oncology Research Unit, Oncology Hospital, National Medical Center, IMSS, México, D.F., Mexico. agustin.aviles@imss.gob.mx
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MeSH Terms
Descriptor/Qualifier:
Adult
Antineoplastic Agents / adverse effects*,  therapeutic use*
Disease-Free Survival
Female
Follow-Up Studies
Hematologic Neoplasms / drug therapy*
Humans
Infant
Infant, Newborn
Male
Pregnancy
Pregnancy Complications, Hematologic / drug therapy*
Pregnancy Complications, Neoplastic / drug therapy*
Pregnancy Trimester, First
Prenatal Exposure Delayed Effects / diagnosis*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents
Comments/Corrections
Comment In:
Int J Cancer. 2013 Apr 1;132(7):1728   [PMID:  22945483 ]
Int J Cancer. 2013 Apr 1;132(7):1729   [PMID:  23015469 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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