Abstract
Cancer and pregnancy induce a procoagulant environment which may lead to maternal
and fetal complications, such as venous thromboembolism, fetal growth restriction,
and fetal loss. The incidence of hematological malignancies diagnosed during pregnancy
is rising, and thrombotic events in such malignancies are not rare. Management of
thrombosis during pregnancy poses a therapeutic challenge, that is further exacerbated
by the impact of cancer. The available data on managing pregnant women with hematological
malignancies are limited to those with myeloproliferative neoplasms, mainly essential
thrombocythemia, and, to a lesser extent, polycythemia vera. Low-dose aspirin is recommended
throughout pregnancy, and considering treatment with low-molecular-weight heparin
and interferon formulations is advised for high-risk patients. Currently, guidelines
for handling thrombotic events in pregnant women with lymphoma or leukemia are lacking,
and their management is based on data extrapolated from retrospective studies, and
guidelines for prevention and treatment of cancer-associated thrombosis. The present
case-based review will focus on the complex issue of thrombotic risk in pregnant women
with hematological malignancies, specifically myeloproliferative neoplasms, lymphomas,
and leukemias.
Keywords
pregnancy - hematological malignancies - thrombosis
