Abstract 4636

Pregnancy as a risk factor for the patients with Hodgkin disease: preliminary report

Grudeva-Popova J1, Nenova I1, Spasova M2

1Department of Oncology and Hematology, 2Department of Pediatrics and Medical Genetic, University Hospital “St George” – Plovdiv, Bulgaria

Hodgkin disease is a potentially curable lymphoid malignancy, affecting predominantly young age. However, subsequent pregnancy in women in child-bearing age, previously diagnosed with Hodgkin disease, may raise some medical and ethical considerations regarding the prognosis of both mother and child. There are few published reports with controversial results about the influence of pregnancy on the duration of remission and overall survival of this subgroup of patients. The objective of the study is to analyze the long-term sequelae of subsequent pregnancy for women previously diagnosed with Hodgkin disease.

Patients and methods

We studied retrospectively 224 patients with Hodgkin disease, diagnosed, treated and followed-up during a 15-year period (1994-2009) at the Department of Hematology and the Department of Oncology and Hematology, University Hospital. Women in child-bearing age numbered 51, and pregnancy after the diagnosis of Hodgkin disease occurred in 5 of them. We analyzed the prognostic factors and possible influence of pregnancy on the duration of remission, and overall survival by logistic regression model and κaplan-Meier survival estimation.

Results

Relapse occurred in 3 out of 5 women with Hodgkin disease. Subsequent pregnancy with fatal outcome occurred in 2 of the 3 soon after delivery. We identified the following prognostically unfavorable factors in this subgroup of patients: advanced clinical stage, presence of B symptoms at the diagnosis of Hodgkin disease, lymphocyte depletion histology, and short time interval between the end of therapy and pregnancy. For the other 2 women pregnancy ended successfully for the mother and child, possibly because of a time interval exceeding 3 years between occurrence of remission and the pregnancy. Median survival time of the observed group was 73 months (95% CI: 10-137) and was shorter, compared to the survival time of the patients in the control group: 212 months (95%CI: 136-288).

Conclusion

The preliminary results of the study of this small subgroup of patients with Hodgkin disease show that women in child-bearing age previously diagnosed with Hodgkin disease, particularly with unfavorable prognosis, have increased relapse risk in case of subsequent pregnancy. The relapse risk appears to be higher in the first 3 years after remission induction.

Disclosures:

No relevant conflicts of interest to declare.

Topics:
hodgkin's disease, pregnancy, disease remission, lymphocyte depletion, lymphoid neoplasm, malignant, prognostic factors, remission induction, recurrence risk, logistic regression, median survival time
*

Asterisk with author names denotes non-ASH members.

© 2009 by The American Society of Hematology
2009
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