What are the treatments for lymphoma during pregnancy?

Pregnancy complicated with malignant lymphoma is uncommon in clinic, but it is very worrying because it threatens the life safety of mother and fetus. In the early stage of pregnancy lymphoma, there may be no obvious systemic symptoms, only lymph node enlargement, which is mostly painless and progressive. The lymph nodes are hard and adhered and fused together, especially the superficial neck, axillary and groin lymph nodes.

The treatment of lymphoma during pregnancy is complex and should be individualized. The pros and cons should be weighed comprehensively according to the parity, severity of the disease during pregnancy, and the duration of pregnancy. Radiotherapy and chemotherapy can control the disease at a considerable stage. Local lesions can be treated with radiotherapy, while extensive lymph node involvement requires systemic chemotherapy. Both radiotherapy and chemotherapy have adverse effects on the mother and fetus. For the mother, it can increase the risk of maternal bleeding and susceptibility to infection; for the fetus, it can cause risks such as fetal malformation, miscarriage, intrauterine growth retardation, and stillbirth.

1. Radiotherapy is suitable for early-stage patients. It involves irradiating the lymph nodes throughout the body. The course of treatment is 6 weeks. The 5-year survival rate is 84%. Patients can survive for 10 years after more than half a year of radiotherapy.

2. Chemotherapy is best with combined chemotherapy, which can significantly improve the prognosis of patients in the advanced stage. Foreign reports show that the complete remission rate of patients in the advanced stage can reach 80% after 6 courses of treatment with the MOPP regimen, and the 5-year disease-free survival rate can reach 68%.

3. Key points of obstetric treatment Pregnancy has no significant effect on the course of this disease, but radiotherapy and chemotherapy during pregnancy can increase the risk of infection and bleeding in the mother, causing fetal malformation and death. Therefore, early pregnancy should be actively terminated, low or medium dose radiotherapy can be tried in the middle and late pregnancy, and regular radiotherapy or chemotherapy can be performed after the pregnancy is over. Prevent bleeding and infection after delivery, pay attention to the general condition of the mother, and give general supportive therapy.