Pregnancy and classic Hodgkin lymphoma: real world outcomes from a single center in Egypt.
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BACKGROUND: Association of pregnancy and Classic Hodgkin lymphoma (CHL) is rare, but clinically important scenario because the peak incidence of CHL overlaps with reproductive years. Management requires balancing maternal disease control with fetal safety. This article aims to explore the clinicopathological characteristics, management challenges, and survival outcomes of CHL female patients in relation to pregnancy. PATIENTS AND METHODS: This is a retrospective study analyzed forty-one female patients in their childbearing period diagnosed with de novo or relapsed/refractory CHL that occurred during pregnancy and treated between 2010 and 2024. RESULTS AND OUTCOMES: Mean age at diagnosis was 25.2 years (SD; 4.9). Thirty-nine patients received ABVD, two received BEACOPP. Complete remission was achieved in 75.6% of patients, with relapse in 6.5%. Median overall survival (OS) for the cohort was 95.33 months (range, 7.1-199.7). Pregnancy outcomes were favorable; most patients delivered full-term infants with no reported congenital anomalies. It appears that CHL and its treatment did not affect fertility and pregnancy itself did not worsen the lymphoma outcomes. CONCLUSION: Management of CHL during pregnancy is a real challenge and requires a multidisciplinary approach with the goal of maximizing the cure rate for the patient, minimizing the fetal risks and allowing delivery of a healthy newborn. ABVD remains safe and effective in pregnancy, with excellent maternal and fetal outcomes.