Transient congenital dilated cardiomyopathy after maternal R-CHOP chemotherapy during pregnancy

• Published in: Reproductive toxicology (Elmsford, N.Y.) N.Y.), 2017-08, Vol.71, p.146-149
• Main Authors: Padberg, Stephanie, Mick, Inge, Frenzel, Cornelia, Greil, Richard, Hilberath, Johannes, Schaefer, Christof
• Format: Article
• Language: English
• Subjects: Adult; Anthracyclines; Antibodies, Monoclonal, Murine-Derived - adverse effects; Antibodies, Monoclonal, Murine-Derived - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cardiomyopathy, Dilated - chemically induced; Cardiomyopathy, Dilated - diagnostic imaging; Cardiomyopathy, Dilated - etiology; Cardiomyopathy, Dilated - physiopathology; Cardiotoxicity; Case report; Cyclophosphamide - adverse effects; Cyclophosphamide - therapeutic use; Diffuse large B-cell lymphoma; Doxorubicin - adverse effects; Doxorubicin - therapeutic use; Echocardiography; Female; Humans; Infant, Newborn; Lymphoma, Large B-Cell, Diffuse - drug therapy; Male; Maternal-Fetal Exchange; Prednisone - adverse effects; Prednisone - therapeutic use; Pregnancy; Pregnancy Complications - drug therapy; Radiography; Vincristine - adverse effects; Vincristine - therapeutic use
• ISSN: 0890-6238; 1873-1708
• DOI: 10.1016/j.reprotox.2017.05.008

Pregnancy-associated diffuse large B-cell lymphoma (DLBCL) is a rare event. Experience regarding fetal effects of maternal treatment during pregnancy is limited. Cardiotoxicity is a known adverse effect of some antineoplastic agents especially of doxorubicin. We report a case of pregnancy-associated DLBCL, which was treated between gestational week 26 and 33 with three cycles of R-CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone combined with rituximab). At gestational age 34 2/7 she delivered a male infant who was admitted to neonatal care due to cardiomyopathy. In the absence of other explanations it was interpreted as a direct toxic effect of maternal chemotherapy. At age 6 months the boy’s cardiac output had normalized. This case report is the first presenting congenital cardiomyopathy after maternal R-CHOP during pregnancy. Since especially anthracyclines are known to cause acute and chronic cardiotoxicity in treated patients, the most probable explanation for neonatal cardiomyopathy in this case is doxorubicin.