SUCCESSFUL PREGNANCY FOLLOWING CONTINUOUS TREATMENT WITH COMBINATION CHEMOTHERAPY BEFORE CONCEPTION AND THROUGHOUT PREGNANCY

A 21-yr-old woman with diffuse histiocytic lymphoma received combination chemotherapy continuously for 16 mo. before conception and throughout pregnancy. Procarbazine and 1,3-bis(2-chloroethyl-1-nitrosourea) were given for 5 mo. before conception and throughout the 1st and 2nd trimesters, and streptozotocin was given throughout the 3rd trimester. A male infant who was phenotypically and genotypically normal was delivered. Literature regarding chemotherapeutic agents given during the 1st trimester of pregnancy was reviewed. Although most chemotherapeutic agents are teratogenic in the animal model, the incidence of teratogenicity of chemotherapeutic agents given to humans in the 1st trimester of pregnancy is 12.7%. This represents a 5-fold increase in teratogenicity. As yet the administration of chemotherapeutic agents in the 2nd and 3rd trimesters has not resulted in teratogenicity. This information may help the physician when deciding whether to treat pregnant patients with chemotherapeutic agents during the 1st trimester or whether to continue treatment when the patient has become pregnant while receiving these agents.