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Non-Hodgkin's Lymphoma During Pregnancy

What is non-Hodgkin's lymphoma?

Adult non-Hodgkin's lymphoma is a disease in which cancer (malignant) cells are found in the lymph system. The lymph system is made up of thin tubes that branch, like blood vessels, into all parts of the body. Lymph vessels carry lymph, a colorless, watery fluid that contains white blood cells called lymphocytes. Along the network of vessels are groups of small organs called lymph nodes. Clusters of lymph nodes are found in the underarm, pelvis, neck, and abdomen. The lymph nodes make and store infection-fighting cells. The spleen (an organ in the upper abdomen that makes lymphocytes and filters old blood cells from the blood), the thymus (a small organ beneath the breastbone), and the tonsils (an organ in the throat) are also part of the lymph system.

Because lymph tissue is found in many parts of the body, non-Hodgkin's lymphoma can start in almost any part of the body. The cancer can spread to almost any organ or tissue in the body, including the liver, bone marrow (the spongy tissue inside the large bones of the body that makes blood cells), spleen, and nose.

There are many types of non-Hodgkin's lymphomas. Some types spread more quickly than others. The type is determined by how the cancer cells look under a microscope. This determination is called the histology. The histologies for adult non-Hodgkin's lymphoma are divided into 2 groups: indolent lymphomas, which are slower growing and have fewer symptoms, and aggressive lymphomas, which grow more quickly.

Indolent Aggressive
Follicular small cleaved cell lymphoma Adult diffuse mixed cell lymphoma
Follicular mixed cell lymphoma Adult diffuse large cell lymphoma
Follicular large cell lymphoma Adult immunoblastic large cell lymphoma
Adult diffuse small cleaved cell lymphoma Adult lymphoblastic lymphoma
Small lymphocytic (marginal zone) Adult small noncleaved cell lymphoma

Other types of indolent non-Hodgkin's lymphoma are lymphoplasmacytoid lymphoma, monocytoid B-cell lymphoma, mucosa-associated lymphoid tissue (MALT) lymphoma, splenic marginal zone lymphoma, hairy cell leukemia, and cutaneous T-cell lymphoma (Mycosis fungoides/Sezary syndrome).

Other types of aggressive non-Hodgkin's lymphoma are anaplastic large-cell lymphoma, adult T-cell lymphoma/leukemia, mantle cell lymphoma, intravascular lymphomatosis, angioimmunoblastic T-cell lymphoma, angiocentric lymphoma, intestinal T-cell lymphoma, primary mediastinal B-cell lymphoma, peripheral T- cell lymphoma, lymphoblastic lymphoma, post-transplantation lymphoproliferative disorder, true histiocytic lymphoma, primary central nervous system lymphoma, and primary effusion lymphoma. Aggressive lymphomas are also seen more frequently in patients who are HIV-positive (AIDS-related lymphoma).

A doctor should be seen if any of the following symptoms persist: painless swelling in the lymph nodes in the neck, underarm, or groin; unexplained fever; drenching night sweats; tiredness; unexplained weight loss in the past 6 months; or itchy skin.

If these symptoms are present, a doctor will carefully check for swelling or lumps in the neck, underarms, and groin. If the lymph nodes don't feel normal, a doctor may need to surgically remove a small piece of tissue and look at it under a microscope to see if there are any cancer cells. This procedure is called a biopsy.

The chance of recovery (prognosis) and choice of treatment depend on the stage of the cancer (whether it is just in one area or has spread throughout the body), and the patient's age and overall condition.

Description

Non-Hodgkin's lymphoma (NHL) usually affects older adults and, therefore, women are seldom found to have NHL when they are pregnant. Most non-Hodgkin's lymphomas are aggressive and delaying treatment until after the baby has been delivered appears to lead to a poor outcome. Immediate treatment is often recommended, even during pregnancy. Children who were exposed to doxorubicin (a chemotherapy drug) before they were born have been monitored for up to 11 years, and they do not appear to suffer from side effects of the drug. Long- term studies have not been conducted to determine the effects of other chemotherapy drugs on children who were exposed to them before birth. Ending the pregnancy during the first trimester of pregnancy may also be an option for women who have aggressive NHL that must be treated immediately. Early delivery may reduce or avoid the fetus' exposure to chemotherapy drugs or radiation therapy. Women who have indolent (slow-growing) non-Hodgkin's lymphoma can usually delay treatment.

To Learn More

Call

For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.

Web sites and Organizations

The NCI's Cancer.gov Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. There are also many other places where people can get materials and information about cancer treatment and services. Local hospitals may have information on local and regional agencies that offer information about finances, getting to and from treatment, receiving care at home, and dealing with problems associated with cancer treatment.

Publications

The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

LiveHelp

The NCI's LiveHelp service, a program available on several of the Institute's Web sites, provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 10:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.

Write

For more information from the NCI, please write to this address:

NCI Public Inquiries Office
Suite 3036A
6116 Executive Boulevard, MSC8322
Bethesda, MD 20892-8322

Source: Cancer.gov
February 2003