Hematological Malignancies and Pregnancy. A Brief Review

Management of hematological malignancies (HM) during pregnancy remains unsolved. Presence of adverse events in mother and child: spontaneous abortion, stillborn, premature, low-weight and congenital abnormalities have been attributed to the use of chemotherapy, especially during first trimester. We reviewed the English and Spanish literature of reports which documented the use of chemotherapy for HM during pregnancy, in order to evaluate the association of adverse events in mother and the fetus. We reviewed 1395 cases of this association, although adverse events was more frequent that did not complicate pregnancy, other causes such as concomitant illness or maternal complications and use of other potentially toxic drugs during pregnancy had not been considered. No clear differences was observed if chemotherapy were administered during 1° or 2° and 3° trimester of pregnancy. Longer follow-up was not available in most reports. We cannot confirm the presence of late toxicity secondary to chemotherapy and radiotherapy, because data are not available. We conclude that the use of chemotherapy can be safely administered during 2° and 3° trimester. Taking into consideration the dates of these brief reports no appear that the use of chemotherapy during first trimester could be dangerous to mother and fetus. It is necessary to consolidate all dates of this association to come to definitive conclusions.