Management of a Woman Diagnosed with Malignant Lymphoma During Pregnancy

indolent non-Hodgkin's lymphoma (NHL)

first trimester (early)

watchful waiting, treat if symptomatic or with disease progression, try to delay chemotherapy to second trimester using steroids as bridge

second or third trimester (late)

watchful waiting, treat if symptomatic or with disease progression

aggressive non-Hodgkin's lymphoma (NHL)

first trimester (early)

terminate pregnancy then treat

second or third trimester (late)

treat as if nonpregnant (including targeted therapy)

highly aggressive non-Hodgkin's lymphoma (CNS prophylaxis required)

<= 20 weeks

terminate pregnancy then treat

> 20 weeks

combination regimen (including high dose methotrexate)

Hodgkin's lymphoma

first trimester (early)

postpone therapy to second trimester if possible; else terminate pregnancy and treat

second or third trimester (late)

treat as if nonpregnant