Pregnancy outcomes related to the treatment of sarcomas with anthracyclines and/or ifosfamide during pregnancy
Abstract Background Sarcomas are rare diagnoses but are seen with relative frequency in adolescents and young adults and thus can present in pregnancy. We sought to study the administration of anthracyclines and/or ifosfamide in pregnancy‐associated sarcomas. Patients and Methods We conducted a mult...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-09-01
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| Series: | Cancer Medicine |
| Online Access: | https://doi.org/10.1002/cam4.4707 |
| _version_ | 1798035745396490240 |
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| author | Devon Miller John A. Livingston Yeonhee Park Kristi Posey Sonia Godbole Keith Skubitz Steven I. Robinson Mark Agulnik Lara E. Davis Brian A. Van Tine Angela C. Hirbe Amanda Parkes |
| author_facet | Devon Miller John A. Livingston Yeonhee Park Kristi Posey Sonia Godbole Keith Skubitz Steven I. Robinson Mark Agulnik Lara E. Davis Brian A. Van Tine Angela C. Hirbe Amanda Parkes |
| author_sort | Devon Miller |
| collection | DOAJ |
| description | Abstract Background Sarcomas are rare diagnoses but are seen with relative frequency in adolescents and young adults and thus can present in pregnancy. We sought to study the administration of anthracyclines and/or ifosfamide in pregnancy‐associated sarcomas. Patients and Methods We conducted a multi‐institutional retrospective study, identifying sarcoma patients who received anthracyclines and/or ifosfamide during pregnancy. Chart review identified variables related to demographics, cancer diagnosis, therapies, and outcome of the patient and fetus. Wilcoxon rank‐sum test compared two independent samples. Results We identified 13 patients at seven institutions with sarcoma who received anthracyclines and/or ifosfamide during pregnancy, including four bone sarcomas and nine soft tissue sarcomas diagnosed at a mean gestational age of 16.7 ± 5.9 weeks. Only nine patients had live births (9/13, 69.2%), with mean gestational age of 30.8 ± 3.8 weeks at delivery. The four patients with pregnancy loss all received both doxorubicin and ifosfamide, with chemotherapy initiated at 15.5 weeks as compared with 21.3 weeks for those patients with live births (p = 0.016). Conclusion In this multi‐institutional study of sarcoma chemotherapy regimens administered during pregnancy, we found a high rate of fetal demise that was seen only in patients receiving both doxorubicin and ifosfamide and statistically more likely with chemotherapy initiation earlier in the second trimester. While limited by a small sample size, our study represents the largest study of sarcoma patients that received anthracyclines and/or ifosfamide in pregnancy thus far reported and supports development of an international registry to study concerns raised by our study. |
| first_indexed | 2024-04-11T21:01:34Z |
| format | Article |
| id | doaj.art-f7d7927540df4dbbbebeb2fc9e9d0ece |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-11T21:01:34Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-f7d7927540df4dbbbebeb2fc9e9d0ece2022-12-22T04:03:28ZengWileyCancer Medicine2045-76342022-09-0111183471347810.1002/cam4.4707Pregnancy outcomes related to the treatment of sarcomas with anthracyclines and/or ifosfamide during pregnancyDevon Miller0John A. Livingston1Yeonhee Park2Kristi Posey3Sonia Godbole4Keith Skubitz5Steven I. Robinson6Mark Agulnik7Lara E. Davis8Brian A. Van Tine9Angela C. Hirbe10Amanda Parkes11University of Wisconsin‐Madison School of Medicine and Public Health Madison Wisconsin USAMD Anderson Cancer Center Houston Texas USADepartment of Biostatistics and Medical Informatics, University of Wisconsin‐Madison Madison Wisconsin USAMD Anderson Cancer Center Houston Texas USAWashington University in St. Louis School of Medicine St. Louis Missouri USAUniversity of Minnesota Minneapolis Minnesota USAMayo Clinic Rochester Minnesota USACity of Hope Duarte California USAOregon Health & Science University Portland Oregon USAWashington University in St. Louis School of Medicine St. Louis Missouri USAWashington University in St. Louis School of Medicine St. Louis Missouri USAUniversity of Wisconsin‐Madison School of Medicine and Public Health Madison Wisconsin USAAbstract Background Sarcomas are rare diagnoses but are seen with relative frequency in adolescents and young adults and thus can present in pregnancy. We sought to study the administration of anthracyclines and/or ifosfamide in pregnancy‐associated sarcomas. Patients and Methods We conducted a multi‐institutional retrospective study, identifying sarcoma patients who received anthracyclines and/or ifosfamide during pregnancy. Chart review identified variables related to demographics, cancer diagnosis, therapies, and outcome of the patient and fetus. Wilcoxon rank‐sum test compared two independent samples. Results We identified 13 patients at seven institutions with sarcoma who received anthracyclines and/or ifosfamide during pregnancy, including four bone sarcomas and nine soft tissue sarcomas diagnosed at a mean gestational age of 16.7 ± 5.9 weeks. Only nine patients had live births (9/13, 69.2%), with mean gestational age of 30.8 ± 3.8 weeks at delivery. The four patients with pregnancy loss all received both doxorubicin and ifosfamide, with chemotherapy initiated at 15.5 weeks as compared with 21.3 weeks for those patients with live births (p = 0.016). Conclusion In this multi‐institutional study of sarcoma chemotherapy regimens administered during pregnancy, we found a high rate of fetal demise that was seen only in patients receiving both doxorubicin and ifosfamide and statistically more likely with chemotherapy initiation earlier in the second trimester. While limited by a small sample size, our study represents the largest study of sarcoma patients that received anthracyclines and/or ifosfamide in pregnancy thus far reported and supports development of an international registry to study concerns raised by our study.https://doi.org/10.1002/cam4.4707 |
| spellingShingle | Devon Miller John A. Livingston Yeonhee Park Kristi Posey Sonia Godbole Keith Skubitz Steven I. Robinson Mark Agulnik Lara E. Davis Brian A. Van Tine Angela C. Hirbe Amanda Parkes Pregnancy outcomes related to the treatment of sarcomas with anthracyclines and/or ifosfamide during pregnancy Cancer Medicine |
| title | Pregnancy outcomes related to the treatment of sarcomas with anthracyclines and/or ifosfamide during pregnancy |
| title_full | Pregnancy outcomes related to the treatment of sarcomas with anthracyclines and/or ifosfamide during pregnancy |
| title_fullStr | Pregnancy outcomes related to the treatment of sarcomas with anthracyclines and/or ifosfamide during pregnancy |
| title_full_unstemmed | Pregnancy outcomes related to the treatment of sarcomas with anthracyclines and/or ifosfamide during pregnancy |
| title_short | Pregnancy outcomes related to the treatment of sarcomas with anthracyclines and/or ifosfamide during pregnancy |
| title_sort | pregnancy outcomes related to the treatment of sarcomas with anthracyclines and or ifosfamide during pregnancy |
| url | https://doi.org/10.1002/cam4.4707 |
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