Obstet Gynecol Sci.  2014 Nov;57(6):526-529. 10.5468/ogs.2014.57.6.526.

Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy for diffuse large B-cell lymphoma in pregnancy may be associated with preterm birth

• Lee EJ
• Ahn KH
• Hong SC
• Lee EH
• Park Y
• Kim BS

• KMID: 2314021
• DOI: http://doi.org/10.5468/ogs.2014.57.6.526

Abstract

Lymphoma, especially non-Hodgkin's lymphoma is extremely rare in pregnancy. A 24-year-old pregnant woman was diagnosed with diffuse large B-cell lymphoma (DLBCL), a subgroup of non-Hodgkin's lymphoma, at 24 weeks' gestation, and was treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy. After 4 cycles of R-CHOP, she delivered a healthy baby via cesarean section at 34 weeks and 5 days' gestation because of preterm contraction-related fetal distress. The patient was administered the remaining 2 cycles of R-CHOP after delivery. Follow-up magnetic resonance imaging and computed tomography showed complete remission. Here, we report a rare case of DLBCL successfully treated with R-CHOP chemotherapy during pregnancy, we also performed a systematic review of literature for similar cases. There were 3 earlier reports of R-CHOP treatment for DLBCL. All cases, including our case, resulted in preterm birth. Together, these findings suggest that R-CHOP chemotherapy for DLBCL in pregnancy may be associated with preterm birth.

Keyword

Chemotherapy; Diffuse large B-cell lymphoma; Pregnancy; Preterm birth; R-CHOP

MeSH Terms

Cesarean Section
Cyclophosphamide*
Doxorubicin*
Drug Therapy*
Female
Fetal Distress
Follow-Up Studies
Humans
Lymphoma
Lymphoma, B-Cell*
Lymphoma, Non-Hodgkin
Magnetic Resonance Imaging
Prednisone*
Pregnancy*
Pregnant Women
Premature Birth*
Vincristine*
Young Adult
Rituximab
Cyclophosphamide
Doxorubicin
Prednisone
Vincristine

Figure

• 

  Fig. 1 (A) A 2.4×1.7-cm lymph node (arrow) in the neck (level IIa), T2 magnetic resonance imaging (MRI). (B) After 4 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy, no masses are seen, T2 MRI. (C) A 5.4×2.5-cm mass (arrow) in the right palatine tonsil, T1 MRI. (D) After 4 cycles of R-CHOP chemotherapy, no masses are seen, T1 MRI.

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