New guidelines have been issued to help with the management of growing numbers of women affected by blood cancer during pregnancy.
The guidelines have been developed in Australia and New Zealand, and published in The Lancet Haematology.
The incidence of blood cancer in pregnancy has increased by about 2.7% a year between 1994 and 2013. Blood cancers now affect about 12.5 of every 100,000 women becoming pregnant in Australia. This is because of delayed age of childbirth, improved diagnosis and increased engagement with health services, the developers say.
The guidance includes recommendations for safe imaging during pregnancy, providing multidisciplinary care, birth management and diagnosis and staging. The guidance also considers the issue of fertility during cancer.
The guidance has the backing of the Society of Obstetric Medicine of Australia and New Zealand and the Haematology Society of Australia and New Zealand.
Dr Georgia Mills, from Macquarie Medical School, Sydney, Australia, said: “Women can experience treatment delays, inaccurate information and communication breakdowns, all of which increase the worry associated with a cancer diagnosis and fears for their unborn baby.
“Patients have also described a lack of sensitivity about fertility preservation, breastfeeding, medication risks to the unborn baby, and a lack of information and support groups. We want women and their babies to experience the best possible health outcomes, not delayed or denied care.”
Senior author Dr Gisele Kidson-Gerber said: “Blood cancers in pregnancy present unique therapeutic challenges, yet there were no clinical guidelines for diagnosis or management. As clinicians, we have to balance the need for optimal treatment for the mother with the safety and wellbeing of the unborn child.
“Most treatments are possible during pregnancy, including many forms of chemotherapy, but this is not what patients expect.”
Source:
Mills G, Shand A, Kennedy D, Lowe S, Bilsland V, Cutts B, McBride B, Brown W, Bolisetty S, Wegner EA, Kidson-Gerber G. (2025) “Position statement on the diagnosis and management of acute leukaemia and aggressive lymphomas in pregnancy.” Lancet Haematology, 3 January 2025, doi: 10.1016/S2352-3026(24)00309-0.
Link: https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(24)00309-0/abstract
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