HEMATOLOGIC NEOPLASMS AND PREGNANCY

Hematologic neoplasms diagnosed during pregnancy, present significant difficulties in patient management. Besides the strictly medical facts , moral, ethical and religious issues shoud be strongly considered. Fo r the optimal management of individual situations an integrated multid isciplinary approach is mandatory. Hodgkin's disease, acute leukemias, non Hodgkin's lymphoma and less frequently chronic myelogenous leukem ia have been reported in pregnant women. Curative treatment for most o f these diseases include intensive chemotherapy regimens. Potential da mage to the fetus is a major concern, due to the teratogenic effects o f antimetabolites, alkylating agents and radiation therapy. Effect of pregnancy in each of these neoplasms is discussed. Although some rules of management exist, dangerous generalizations should be avoided. Par ticular obstetric considerations such as timing of delivery, and thera peutic abortion should be carried out on an individual basis. The emot ional impact of the situation must not be underestimated.