Increased Incidence of Villitis in Placentas Exposed to Chemotherapy During Pregnancy: Is There a Correlation?

We have identified 9 pregnant patients who were diagnosed with malignancy and initiated chemotherapy during their second trimester (cervical cancer [n = 3], leukemia [n = 3], breast cancer [n = 2], and Hodgkin’s lymphoma [n = 1]). Five of the patients’ placentas were small for gestational age (SGA)....

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Bibliographic Details
Published in:Pediatric and developmental pathology 2019-12, Vol.22 (6), p.540-545
Main Authors: Kantarovich, Diana, Archer, Sydney, Khoshnam, Nasim, Al-Haddad, Eman, Moncaleano, Daniela, Demian, Sherry, Jacob, Angela M, Shehata, Bahig M
Format: Article
Language:English
Subjects:
Adult
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Biomarkers - metabolism
Chorionic Villi - drug effects
Chorionic Villi - metabolism
Chorionic Villi - pathology
Female
Humans
Immunohistochemistry
Inflammation - chemically induced
Inflammation - diagnosis
Inflammation - epidemiology
Inflammation - pathology
Male
Placenta Diseases - chemically induced
Placenta Diseases - diagnosis
Placenta Diseases - epidemiology
Placenta Diseases - pathology
Pregnancy
Pregnancy Complications, Neoplastic - drug therapy
Retrospective Studies
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Summary:We have identified 9 pregnant patients who were diagnosed with malignancy and initiated chemotherapy during their second trimester (cervical cancer [n = 3], leukemia [n = 3], breast cancer [n = 2], and Hodgkin’s lymphoma [n = 1]). Five of the patients’ placentas were small for gestational age (SGA). Pathologic examination revealed inflammatory changes in 4 of the placentas: 2 from the SGA placentas and 2 from non-SGA placentas. Examination revealed 3 placentas with villitis of unknown etiology (VUE) and 1 with intervillositis; all were negative for bacterial and viral cultures and by immunohistochemical (IHC) stains. In the VUE cases, IHC stains showed positivity of CD25+/FOXP3+ with focal positivity and CD3 and CD4 IHC were focally to strongly positive. Literature suggests that the use of chemotherapy during pregnancy can be detrimental to both the mother and the fetus; however, there has been limited focus on the effects of chemotherapy on the placenta. We suggest that the inflammatory process noted in the placentas is due to chemotherapy-induced toxic effects.
ISSN:1093-5266
1615-5742
DOI:10.1177/1093526619853179