Hodgkin Lymphoma Treatment During Pregnancy

If a woman is pregnant and diagnosed with Hodgkin lymphoma (HL), treatment options depend on several factors. The woman and her doctors (including her obstetrician) must think about the extent or stage of the lymphoma, how quickly it's growing, how far along the pregnancy is, and the woman’s own personal preferences.

If the HL needs to be treated during the pregnancy, it's delayed until after the first trimester, if possible. This is because the risks to the baby are lower after the first 3 months. Treatment is usually chemotherapy using either one or a few drugs (often the ABVD combo), based on the situation.

If HL is diagnosed during the second half of the pregnancy and isn't causing problems, a woman can often wait until the baby is born before starting treatment. This approach is safest for the baby. (Sometimes labor is induced a few weeks early and treatment is started right away.)

Radiation therapy is not often given during pregnancy because of concerns about the possible long-term effects on the unborn baby. Not all experts agree, but some say that as long as very careful precautions are taken to aim the radiation precisely, limit the doses, and shield the baby, pregnant women with HL in lymph nodes in the neck, underarm area, or inside the chest can get radiation with little or no apparent risk to the baby. If radiation is given, it should be delayed until at least the second trimester, if possible. To date, studies haven't found that delaying radiation treatment is harmful for the mother.

The need to avoid radiation also limits which imaging tests can be used to help determine the stage (extent) of the lymphoma and see if treatment is working. CT scans, PET scans, and x-rays all use radiation, so they're avoided if at all possible. MRI scans and ultrasound can be used instead.