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Teams from the departments of clinical and biological hematology, obstetrics and gynecology, pharmacovigilance, medical intensive care, infectiology, as well as the clinical research unit of theHôpital Cochin-Port Royal AP-HP, Université Paris Cité, Inserm and the HEMAPREG network, coordinated by Mr Pierre Pinson and Drs Ismael Boussaid and Rudy Birsen, have conducted a study on pregnancy-associated hematological cancers. The results of the HEMAPREG study were published in The Lancet Haematology on October 7, 2024 .
The occurrence of haematological cancer (haematological malignancy) during pregnancy presents a number of diagnostic and therapeutic challenges. Two imperatives need to be reconciled: optimal treatment of the maternal disease and consideration of the risks to which the fetus may be exposed. Given the rarity of these events, the data available to help make medical decisions and inform women and their families is currently limited.
The HEMAPREG study is based on a national cohort drawn from the French National Health Data System (SNDS). It has several key objectives, including assessing the incidence of hematological malignancies occurring during pregnancy in France, analyzing maternal and obstetric complications, and obtaining robust epidemiological data that could orient medical practices and guide the care and information of these women in this complex clinical context.
The study included all women in France whose pregnancies ended between January 1, 2012 and December 31, 2022. Pregnancies ending in miscarriage or elective termination that were not managed in hospital were excluded, as were women with a history of hematological malignancies prior to pregnancy.
Between 2012 and 2022, in France, out of a total of 9,996,523 pregnancies, 1,366 cases of pregnancy-associated hematological cancers were identified, representing a frequency of 13.66 per 100,000 pregnancies. Of these, 413 cases were diagnosed during pregnancy, with a frequency of 4.13 per 100,000 pregnancies, and 953 cases in the year following pregnancy, or 9.53 per 100,000 pregnancies. The study also shows a higher rate of premature births for these women (45.2%) than for women without hemopathy (6.6%).
This study also showed that women with haematological malignancies during pregnancy had the same probability of long-term survival as women with haematological malignancies who were not pregnant. Thus, being pregnant at the time of diagnosis had no negative impact on the long-term survival of these patients.
These results highlight the importance of multidisciplinary care in specialized centers, to ensure optimal management of these high-risk situations. This study is also a resource for healthcare professionals faced with these cases, providing essential information to better inform women and involve them in therapeutic decisions and care planning, thus promoting informed and shared management.
The HEMAPREG network is made up of researchers and caregivers involved in the care of women suffering from hematological malignancies during pregnancy or in the year following. Its aim is to carry out and promote fundamental, translational and clinical research into these diseases, and to improve the care and treatment of these patients.
