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Pregnancy and the Risk of Relapse in Patients Diagnosed With Hodgkin Lymphoma
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2016 (English)In: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 34, no 4, 337-+ p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Many patients and clinicians are worried that pregnancy after the diagnosis of Hodgkin lymphoma (HL) may increase the risk of relapse despite a lack of empirical evidence to support such concerns. We investigated if an association exists between pregnancy and relapse in women with a diagnosis of HL.

MATERIALS AND METHODS: Using Swedish healthcare registers combined with medical records, we included 449 women who received a diagnosis of HL between 1992 and 2009 and who were age 18 to 40 years at diagnosis. Follow-up started 6 months after diagnosis, when the patients' condition was assumed to be in remission. Pregnancy-associated relapse was defined as a relapse during pregnancy or within 5 years after delivery. Hazard ratios (HRs) with 95% CIs were estimated by using the Cox proportional hazards model.

RESULTS: Among the 449 women, 144 (32%) became pregnant during follow-up. Overall, 47 relapses were recorded, of which one was a pregnancy-associated relapse. The adjusted HR for the comparison of the pregnancy-associated relapse rate to the non-pregnancy-associated relapse rate was 0.29 (95% CI, 0.04 to 2.18). The expected number of relapses in women with a recent pregnancy, given that they would experience the same relapse rate as that of women without a recent pregnancy, was 3.76; the observed-to-expected ratio was 0.27 (95% exact CI, 0.01 to 1.51).

CONCLUSION: We found no evidence that a pregnancy after diagnosis increases the relapse rate among women whose HL is in remission. Survivors of HL need to consider a range of factors when deciding about future reproduction. However, given the results of this study, the risk of pregnancy-associated relapse does not need to be considered.

Place, publisher, year, edition, pages
2016. Vol. 34, no 4, 337-+ p.
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Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-270343DOI: 10.1200/JCO.2015.63.3446ISI: 000374331500012PubMedID: 26668344OAI: oai:DiVA.org:uu-270343DiVA: diva2:889602
Funder
Swedish Cancer SocietyThe Karolinska Institutet's Research Foundation
Available from: 2015-12-27 Created: 2015-12-27 Last updated: 2017-12-01Bibliographically approved

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Glimelius, Ingrid

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