Annals of Oncology 15:146-150, 2004
© 2004 European Society for Medical Oncology
Original Paper |
Anthracyclines during pregnancy: embryo–fetal outcome in 160 patients
Received 7 April 2003; revised 18 July 2003; accepted 13 August 2003Background:
Anthracyclines are essential for the treatment of malignancies observed in pregnant patients. Knowledge of the potential side-effects of chemotherapy on the developing fetus is essential for patient counseling.
Patients and methods:
We collected information concerning patients treated with anthracyclines during pregnancy from a review of literature between 1976 and 2001 and our experience. The events analyzed were malformations, fetal death and spontaneous abortion. A 
2 test with a Yates correction was used to compare the distribution of severe events.
Results:
A total of 160 patient pregnancies were analyzed. The fetal outcome was frequently normal (73%). Abnormalities included malformations (3%), fetal death (9%), spontaneous abortion (3%), fetal complications (8%) and prematurity (6%). Fetal death was often directly consecutive to maternal death (40%). Unfavorable fetal outcome was significantly more frequent in leukemia patients (P = 0.001). In patients with solid tumors, the first trimester was significantly associated with more complications (P = 0.029). The risk of severe fetal toxicity was increased 30-fold when the dose of doxorubicin per cycle exceeded 70 mg/m2 (P = 0.037).
Conclusions:
Anthracyclines may induce embryo–fetal toxicity. Nevertheless the risk seems low, especially after the first trimester and using doses of doxorubicin below 70 mg/m2.
1 Unité d’Oncologie Médicale, Service de Médecine Interne, Paris; 2 Maternité Port Royal, Groupe Hospitalier Cochin, AP-HP, Paris, France
Key words: anthracyclines, fetal outcome, pregnancy, transplacental passage
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