Rituximab-containing chemotherapy in pregnancy with malignancy

Non-Hodgkin lymphoma diagnosed during pregnancy often has an aggressive histology, with diffuse large B-cell or peripheral T-cell lymphomas being most common in this context. Aggressive lymphomas during pregnancy present a difficult challenge in diagnosis, especially in staging by means of radiological evaluation. The aim of the treatment is to give the mother the best chance for cure but at the same time with minimal harm to the fetus. Most cytotoxic agents, including rituximab, cross the human placenta and reach the fetus. Rituximab-based chemotherapy (R-CHOP) is now considered the standard of care and generally considered safe for the treatment of aggressive lymphomas during pregnancy except during the first trimester.