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Hämatoonkologische Erkrankungen in der Schwangerschaft

Behandlungsoptionen, Probleme und Herausforderungen

Hematological and non-gynecological malignancies in pregnancy

Treatment options, problems and challenges

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Der Gynäkologe Aims and scope

Zusammenfassung

Hämatoonkologische Erkrankungen in der Schwangerschaft bringen die Schwangere und den behandelnden Arzt in eine konfliktreiche Ausnahmesituation. Eine Heilung oder Lebenszeitverlängerung der Mutter und die Protektion des Ungeborenen vor toxischen Therapieeinflüssen gilt es gegeneinander abzuwägen. Tumorentität, Stadium und Prognose sowie Gestationsalter sind für die Behandlungsplanung von zentraler Bedeutung. Die interdisziplinäre Betreuung der Ratsuchenden ist unerlässlich. Im Beitrag wird eine Übersicht über die Datenlage zur Anwendung von Standardzytostatika und „neueren Substanzen“ in der Schwangerschaft und dem Risiko der Fruchtschädigung gegeben. Eingegangen wird auf Diagnostik und Therapie hämatologischer Neoplasien sowie solider Karzinome und Einblicke werden gegeben in die für Betroffene, Angehörige und Behandelnde komplexen Entscheidungs- und Belastungssituationen.

Abstract

The concomitant occurrence of cancer and pregnancy causes a dilemma for the woman and physicians alike. The requirement for maternal cure or lifetime prolongation and fetal protection against treatment-related adverse effects are ambitious aims. The tumor entity and stage, the prognosis and the gestational age are of utmost importance for the therapeutic strategy. The clinical care of these women requires multidisciplinary consultation. In the article we review the database for chemotherapy treatment standards and “new substances” given during pregnancy and their teratogenic risk. We also briefly evaluate the staging, diagnostic procedures and therapeutic strategies for hematological neoplasms and solid carcinomas as well as the complex emotional dilemma for the expectant mother, her family and physicians.

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Authors and Affiliations

  1. Medizinische Klinik I, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt/Main, Deutschland

    C. Bolling

  2. Medizinische Klinik I, Funktionsbereich Psychoonkologie, Agaplesion Markus Krankenhaus, Frankfurt/Main, Deutschland

    S. Schuster

  3. Klinik für Gynäkologie und Geburtshilfe, Agaplesion Markus Krankenhaus, Frankfurt/Main, Deutschland

    J. Pfeiffer

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  1. C. Bolling
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  2. S. Schuster
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  3. J. Pfeiffer
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Correspondence to C. Bolling.

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Bolling, C., Schuster, S. & Pfeiffer, J. Hämatoonkologische Erkrankungen in der Schwangerschaft. Gynäkologe 45, 951–958 (2012). https://doi.org/10.1007/s00129-012-3030-9

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