MANAGEMENT OF PATIENTS WITH EVOLUTIVE MAL IGNANT BLOOD-DISEASES AND PREGNANCY

Pregnancy coexisting with evolutive malignant blood disease (Hodgkin's disease, acute leukemia, non-Hodgkin's lymphoma, chronic myeloprolife rative disorder) is a therapeutic dilemma because of possible adverse reactions associated with the use of cytostatic agents. Therapeutic ab ortion, when needed, must be proposed only after a careful evaluation of the following parameters: the emergency of treatment, the prognosis of the disease, the term of pregnancy, the risks of therapy for the f oetus and the mother, and the psychosocial context. From the clinical data published so far, the teratogenicity of cytostatic drugs seems to be minimal after the second trimester, and the outcome of pregnancy i s often favorable, whatever the hemopathy. Radiation therapy must be u sed very cautiously and only in supradiaphragmatic areas. An overview of specific specific problems is done for each category of malignant b lood disease.