The teams from the departments of clinical and biological hematology, obstetrics and gynecology, pharmacovigilance, medical intensive care, infectious diseases, as well as the clinical research unit of the Cochin-Port Royal AP-HP hospital, the Paris Cité University, Inserm, and the HEMAPREG network, coordinated by Mr. Pierre Pinson and Doctors Ismael Boussaid and Rudy Birsen, carried out a study on hematological cancers associated with pregnancy. The results of this HEMAPREG study were the subject of a publication published on October 7, 2024 in the journal The Lancet Haematology.
The occurrence of hematological cancer (malignant hemopathy) during pregnancy represents a situation which poses diagnostic and therapeutic challenges. It is indeed a question of reconciling two imperatives: the optimal treatment of maternal illness and considering the risks to which the fetus may be exposed. Given the rarity of these events, the data available to make medical decisions and inform women and their families is currently limited.
The HEMAPREG study is based on a national cohort from the National Health Data System (SNDS). It has several key objectives, including the evaluation of the incidence of hematological malignancies occurring during pregnancy in France, the analysis of maternal and obstetric complications but also the obtaining of robust epidemiological data which could guide medical practices and guide the care and information for 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 voluntary termination of pregnancy for which management was not included were excluded. was not hospitable, as well as women with a history of hematologic malignancies before pregnancy.
Between 2012 and 2022, in France, out of a total of 9,996,523 pregnancies, 1,366 cases of hematological cancers associated with pregnancy were identified, which represents 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%) compared to women without hemopathy (6.6%).
This study also shows that women with hematological malignancies during pregnancy had the same probability of long-term survival as women with hematological malignancies who were not pregnant. Thus, being pregnant at the time of diagnosis does not negatively impact the long-term survival of these patients.
These results highlight the importance of multidisciplinary care in specialized centers, in order to guarantee optimal management of these high-risk situations. This study also constitutes a resource for health professionals confronted with these cases, by providing essential information to better inform women and involve them in therapeutic decisions and care planning, thus promoting informed and shared care.
The network HEMAPREG is made up of researchers and caregivers involved in the care of women suffering from hematologic malignancies occurring during pregnancy or in the year following. Its objective is to carry out and promote fundamental, translational and clinical research on these diseases, and to improve the care and treatment of these patients.
