(P110) Hodgkin Lymphoma and Pregnancy: Treatment Patterns and Survival Outcomes of Women Treated With Modern Chemotherapy and Radiotherapy

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OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

Overall, outcomes in patients diagnosed with HL in pregnancy in the modern era of chemotherapy and radiation are good. As in HL not diagnosed during pregnancy, outcomes are better in patients with a complete response following initial therapy. Delaying all therapy until the postpartum period is appropriate in properly selected patients and is not associated with poorer outcomes.

Eleanor Osborne, MD, Michelle Fanale, MD, Leslie Ballas, MD, Yasuhiro Oki, MD, Andrea Milbourne, MD, Grace Smith, MD, PhD, Sarah Milgrom, MD, Valerie Reed, MD, Isidora Arzu, MD, Bouthaina Dabaja, MD, Chelsea Pinnix, MD, PhD; UT MD Anderson Cancer Center; University of Southern California

PURPOSE: Hodgkin lymphoma (HL) is the fourth most common malignancy diagnosed during pregnancy. However, the appropriate management of HL during pregnancy is disputed, and the effect of suboptimal staging imaging and modified treatment regimens is unclear. Here, we report treatment approaches and survival outcomes of pregnancy-associated Hodgkin disease at our institution.

METHODS: We performed a single-institution, retrospective analysis of 36 women diagnosed with HL during pregnancy between 1991 and 2014. Kaplan-Meier and chi-square analyses were used to determine survival outcomes.

RESULTS: Of the initial 36 charts reviewed, 6 patients were excluded due to inadequate long-term follow-up. Among the 30 remaining patients, 24 patients (80%) had stage I/II disease. Six patients had B symptoms (20%). The median gestational age at diagnosis was 20 weeks (range: 2–37 wk), with most patients (60%) being diagnosed in the second trimester. A total of 19 patients (63%) initiated treatment while pregnant (4 with radiation, 15 with chemotherapy). Two women terminated their pregnancies to initiate treatment, and there were two spontaneous abortions in women who initiated chemotherapy at 4 weeks and 15 weeks of gestation. Further, 18 women (60%) had full-term pregnancies (> 37 wk gestation); the median gestational age at delivery was 37 weeks (range: 26–42 wk). A total of 15 women (50%) received both chemotherapy and radiation, 10 (33%) received chemotherapy alone, and 5 (17%) received radiation alone. The majority of patients had a complete response after finishing therapy, but six women (20%) had progressive or primary refractory disease, and six women (20%) relapsed.

After a median follow-up of 57.5 months, the mean progression-free survival (PFS) was 43.4 months (range: 1–261 mo), and the mean overall survival (OS) was 80.8 months (range: 8–273 mo). Patients with progressive or primary refractory disease had poorer outcomes (mean PFS: 10.3 mo vs 49.3 mo, P < .0001; mean OS: 31.2 mo vs 93 mo, P = .0031). Initiating treatment during pregnancy was not associated with improved outcomes (mean PFS: 13.4 mo vs 46.7 mo, P = .89; mean OS 41.5 mo vs 85.3 mo, P = .81).

CONCLUSION: Overall, outcomes in patients diagnosed with HL in pregnancy in the modern era of chemotherapy and radiation are good. As in HL not diagnosed during pregnancy, outcomes are better in patients with a complete response following initial therapy. Delaying all therapy until the postpartum period is appropriate in properly selected patients and is not associated with poorer outcomes.

Proceedings of the 97th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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