Purpose: To assess longer follow-up (more of 20 years) in children whose received chemotherapy during pregnancy, to detect the risks that can appear an late adult life

Patients: All children ( now: adults) were analyzed the presence of some severe health problems , that can be associated with the use of cytotoxic drugs , also the academic and work if they present some problems with learning, environment, behavior , social development and parenthood

Results: At longer time, median 23.4 (range 16-37) years, 201 children are alive, with a normal social, academic and working situations. One, die at 17 years (suicide associate to drugs). No cardiac, neurological damage were observed. Different disease were according to the age, only a case of diabetes mellitus were observed. Presence of any type of cancer were not observed. The social, academic, working and social environment were normal according to the economic status.

Conclusion: In this final report of our group, we confirmed that the use of chemotherapy during pregnancy did not affect the life of children, and the use of adequate treatment improved the outcome of the mothers.

• Chemotherapy; Pregnancy; Children; Cancer

Aviles A, Macias P (2024) Current Status of 202 Children Who Received Chemotherapy during Pregnancy. J Hematol Transfus 11(1): 1121

Greater advances has been achieved in the management of pregnant patients and cancer; fifty years ago, the treatment in this condition, were based in single cases, in most cases abortion was suggested , but the use of abortion was refused by legal, religious and familiar reasons. The use of chemotherapy was considered dangerous to the fetus, considered that could be associated to congenital malformations, premature neonate , low weight ; and not information about the clinical evolution of mothers and children [1]. Thus, during years, most cases of this associated were reported, and it necessary to performed an group of specialist that can will defined the best treatment for any type of cancer, also, to improve the nutritional status, physiological support for mother and family, determine the time and type of delivery, and the most important performed an follow-up, in mothers to analyze the cancer response, possible relapses, if the mother show un longer time , if they show any abnormalities in yours life style, fertility, also, the children will be follow to analyses the impact of chemotherapy that were employed during pregnancy. Unfortunately, in most studies the follow-up of children were performed until 18 years. Thus, in our Institute we have a team, and we can performed longer follow-up of our patients. We performed an analysis of children for UN longer time: 23.4 median (range 16 -37) years to assess the presence of very late (> 20 years) in children who received chemotherapy during pregnancy [2-5].

Previously we reported the outcome of 202 children whose received chemotherapy during pregnancy, until 18 years, thus we continue the follow of the patients from 23.4 median (range 16-37) years.

Medical assisted performed annual visit from patients there remain in the school, and in the professional era, also revised the electronic files to search if the patient had any health problem, the course and resolution of the problem, if the patient had an serious problem, we solicited to the familial doctor that send the patient an our hospital. For female patient, asked gynecology development, if they were pregnant, about the course and resolution, and the weight at born and if any congenital abnormalities were observed.

If any disease was diagnosed, the treatment, control of disease and if observed any complications. Moreover, revised the electronic files of all patients to search any healthy problem, and in special cases revised the patient. No specific studies were conducted to assess the possibility of cardiac or neurological abnormalities, because, considered that taking in consideration that the longer time of the apparition of any problem cannot be attributed to the chemotherapy that had received during pregnancy.

Table 1 show the most important dates in the adult life of these patients.

Median age varied between 24 to 30 years. The scholarship was limited to economic and social status. Neither of the children shown and problem in learning, calcifications, psychological, social and behavior. When the medical assistant visit, all friendly accepted and contest all questions. The most common problems were accidents (6 cases), all car involved. Two patient’s suicide in relationship with drugs. Systems disease were similar with our national tendency. Until now, no cardiac or neurological diseases has been observed. Neither type of cancer were observed.

During years, the treatment of cancer during pregnancy were controversial, because the use of chemotherapy was associated to low-weight, spontaneous abortion, intrauterine fetal death, high number of neonatal infections, congenital malformations. However, this were anecdotical reports. Initially the treatment with chemotherapy in patients with pregnancy were employed in women in second and third trimester to avoid the risk of congenital malformations. At the same time was evident that pregnant women with cancer need a complex support during pregnancy, a nutritionist that controlled the indigest of an appropriate diet, rich in proteins, and suitable supplements, as folate, vitamins. A gynecologist with experience in high risk pregnancy, psychological support, and neologist to evaluate the newborn. An oncologist and hematologist to defined the best therapeutically scheme, and the minimal toxicities. After delivery, and close follow-up to detect the presence on any abnormalities, in special cardiac, and neurological, included development of the capacity in learning, scholar attendance, social development [6- 11].

In this study, we did not detect any cardiac, neurological, learning, school attendance, social development, most of these children finalized university school, and had an excellent work. If they desire to have children, no obstetric, gynecological development parenthood were excellent. Recently we analyzed the mothers and they were matched with no pregnant with the same hematological malignancy, similar treatment and response, and surprisingly, mothers with pregnancy have better overall survival compared with 52 no pregnant women [12]. Thus it was considered that pregnancy could have any benefit in patients with hematological malignancies or is the result of the close follow that can detect early disease and have a better attention.

Thus, some health problems could be detected early and improve with a better treatment, also if the detect disease have any complications, the medical assisted promotes that the patient has translate into a second level. Also the same patients had a different life style, performed more physical, exercise, a better alimentation, and avoid smoked and liquors.

Thus, in this final report we confirm that the treatment of cancer during pregnancy, could be performed, and will be treated with the cure condition. In patients with hematological malignancies, pregnant patients have an excellent outcome, when compared with no-pregnant patients. Also, we confirm that the children have a normal life without acute and late toxicities, and during adult life, is was completely normal, with biological, intellectual, social interchange, marriage, parenthood development. Also, those newborns and children are normal and clinically did not show an abnormal of congenital malformations, or development of any type of cancer.

Of course, is necessary one expert working team, to achieved good results: mothers alive, and newborns that can achieve a normal life?

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