Clinicopathological features and outcomes: analysis of 21 cases of lymphoma in pregnancy

Objective: To evaluate the clinicopathological features and outcomes of lymphoma in pregnancy.

Methods: A total of 21 patients with lymphoma in pregnancy were diagnosed and treated at our hospital between January 1999 and January 2012. The clinicopathological data were analyzed retrospectively.

Results: There were 11 cases of Hodgkin's lymphoma (HL) and 10 cases of nodular sclerosis classical Hodgkin's lymphoma (NSCHL). And, among 10 cases of non-Hodgkin's lymphomas (NHL), there were diffuse large B cell lymphoma (n = 6),B-cell lymphoma, non-classifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma (n = 1), small lymphocytic lymphoma (n = 1), anaplastic large cell lymphoma with anaplastic lymphoma kinase (ALK) positive (n = 1) and T-cell lymphoblastic lymphoma (n = 1). The median age was 26(22-35) years.Superficial lymphadenopathy was more common in HL than in NHL (10/11 vs 3/10, P = 0.008). At diagnosis, bulky disease and extranodal involvement were more prevalent in NHL than in HL (8/10 vs 2/11, P = 0.009; 7/10 vs 2/11, P = 0.030). All patients received chemotherapy and those with early stages also had combined radiotherapy. Ten patients with HL and 6 patients with NHL achieved complete remission. During a median follow-up of 90 months for HL, the 5-year progression-free survival (PFS) and overall survival (OS) rates were 87.5% and 100% respectively. And during a median follow-up of 31 months for NHL, the 2-year PFS and OS rates were 66.7% and 77.8% respectively. The values of PFS and OS of NHL were inferior to those of HL (P = 0.073 and P = 0.066 respectively).One case of HL and 1 case of NHL received chemotherapy in the second trimester. The patients and their children experienced good outcomes.

Conclusions: NSCHL is the most prevalent subtype of HL during pregnancy. B cell lymphoma and aggressive subtypes are most common for NHL during pregnancy. The outcomes of NHL are inferior to those of HL during pregnancy.