Hodgkin Lymphoma and Pregnancy: What Families Demand to Know

When a young woman is diagnosed with Hodgkin lymphoma while pregnant, it creates a complex medical situation that requires careful coordination between oncology and obstetrics teams. Recent news about the wife of Minnesota Twins reliever Kody Funderburk facing Hodgkin lymphoma while expecting her first child has brought public attention to this rare but manageable scenario. While specific details about her case remain private, medical experts confirm that with timely diagnosis and specialized care, many women can successfully undergo treatment for Hodgkin lymphoma during pregnancy and deliver healthy babies.

This article provides evidence-based information about Hodgkin lymphoma in pregnancy, based on current medical guidelines and peer-reviewed research, to aid patients and families understand what to expect.

Understanding Hodgkin Lymphoma

Hodgkin lymphoma is a type of cancer that originates in the lymphatic system, which is part of the body’s immune system. It occurs when lymphocytes (a type of white blood cell) grow abnormally and may spread beyond the lymphatic system.

According to the American Cancer Society, Hodgkin lymphoma is most commonly diagnosed in people between the ages of 15 and 35, making it one of the more frequent cancers encountered during pregnancy. The disease is characterized by the presence of Reed-Sternberg cells, which can be identified under a microscope.

Common symptoms include swollen lymph nodes (often in the neck, armpits, or groin), fatigue, night sweats, unexplained weight loss, and fever. However, some of these symptoms can overlap with normal pregnancy changes, which is why persistent or worsening signs should always be evaluated by a healthcare provider.

Diagnosing Hodgkin Lymphoma During Pregnancy

Diagnosing lymphoma in pregnancy requires special consideration to protect both the mother and developing fetus. Medical professionals use a combination of tools, prioritizing tests with minimal radiation exposure.

According to guidelines from the American Society of Clinical Oncology (ASCO) and the American College of Obstetricians and Gynecologists (ACOG), the diagnostic process typically includes:

• Physical examination focusing on lymph node areas
• Blood tests to assess overall health and liver/kidney function
• Safe imaging techniques such as ultrasound and magnetic resonance imaging (MRI) without contrast
• When necessary, a biopsy of an affected lymph node (considered safe during pregnancy)

Positron emission tomography (PET) scans, which use radioactive tracers, are generally avoided during pregnancy unless absolutely essential, due to potential radiation exposure to the fetus. If imaging is needed, doctors carefully weigh the benefits against risks and often prefer MRI as a safer alternative.

Treatment Options for Hodgkin Lymphoma in Pregnancy

Treatment decisions depend on several factors, including the stage of cancer, how fast it is growing, the trimester of pregnancy, and the mother’s overall health. The goal is to effectively treat the lymphoma while minimizing risk to the fetus.

Research published in journals like The Lancet Oncology and Journal of Clinical Oncology shows that outcomes for pregnant women with Hodgkin lymphoma are generally favorable when managed by a multidisciplinary team.

Key treatment considerations include:

First Trimester

During the first 12 weeks of pregnancy, when fetal organs are forming, chemotherapy is typically avoided due to the highest risk of birth defects. If treatment is urgently needed, options may include:

• Close monitoring if the cancer is slow-growing
• In rare cases, incredibly limited and targeted chemotherapy regimens under strict supervision
• Delivery planning if the fetus is viable (though this is uncommon in the first trimester)

Second and Third Trimesters

After the first trimester, the risk of chemotherapy causing major birth defects decreases significantly. Certain chemotherapy drugs have been studied and used safely during pregnancy, particularly:

• ABVD regimen (doxorubicin, bleomycin, vinblastine, dacarbazine): This is the most commonly used chemotherapy combination for Hodgkin lymphoma and has the most safety data in pregnancy.
• Studies indicate that when administered after the first trimester, ABVD does not significantly increase the risk of congenital malformations, though close fetal monitoring is still recommended.

According to a 2018 study in Blood Advances, pregnant women treated with ABVD chemotherapy after the first trimester had similar rates of live births and infant health outcomes compared to women without cancer, although there was a slightly increased risk of preterm birth.

Radiation therapy is generally avoided during pregnancy, especially to the pelvic or abdominal areas, due to potential harm to the fetus. If radiation is absolutely necessary, shielding techniques and precise targeting are used to minimize exposure, and it is often postponed until after delivery when possible.

Delivery and Postpartum Care

Many women with Hodgkin lymphoma are able to carry their pregnancies to term or near-term. Delivery timing is carefully planned based on both obstetric and oncological considerations.

In cases where chemotherapy is ongoing, delivery may be scheduled a few weeks before the next cycle to allow the mother’s blood counts to recover, reducing the risk of complications like infection or bleeding during labor.

After delivery, treatment can often be intensified if needed. Breastfeeding decisions are made on a case-by-case basis, as some chemotherapy drugs can pass into breast milk. Oncologists and lactation consultants work together to guide mothers on safe feeding options.

Prognosis and Long-Term Outlook

The prognosis for Hodgkin lymphoma is generally excellent, with high cure rates even in advanced stages when treated appropriately. For pregnant women, outcomes are similarly positive when treatment is initiated promptly.

Data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program shows that the 5-year relative survival rate for Hodgkin lymphoma is approximately 88% and exceeds 90% for early-stage disease.

Importantly, being treated for Hodgkin lymphoma during pregnancy does not appear to increase the risk of cancer recurrence or negatively impact long-term survival, provided treatment is completed as recommended.

Support and Resources

A cancer diagnosis during pregnancy can be emotionally overwhelming. Access to psychological support, counseling, and peer networks is a vital part of comprehensive care.

Organizations such as the Leukemia & Lymphoma Society (LLS) and American Cancer Society offer specific resources for young adults and pregnant individuals facing cancer, including:

• Information hotlines staffed by oncology nurses
• Support groups for women with cancer during pregnancy
• Financial assistance programs for treatment-related costs
• Guidance on navigating work, insurance, and family leave

Hospitals with maternal-fetal medicine specialists and oncology teams often have dedicated programs to coordinate care for pregnant patients with cancer, ensuring that both maternal and fetal health are prioritized throughout treatment and delivery.

Key Takeaways

• Hodgkin lymphoma is one of the more common cancers diagnosed during pregnancy, particularly in women aged 15–35.
• Diagnosis relies on safe imaging (ultrasound, MRI) and biopsy, avoiding unnecessary radiation exposure.
• Chemotherapy with the ABVD regimen can be administered safely after the first trimester, with close monitoring.
• Radiation therapy is generally avoided during pregnancy unless absolutely essential and carefully shielded.
• Many women are able to deliver healthy babies while undergoing or after completing treatment.
• Long-term survival rates remain excellent with timely, multidisciplinary care.
• Emotional and practical support is crucial and widely available through cancer support organizations.

Frequently Asked Questions

Can Hodgkin lymphoma harm the baby during pregnancy?

The cancer itself does not spread to the fetus. However, treatments like chemotherapy and radiation can pose risks, which is why timing and type of therapy are carefully managed. When treatment is administered appropriately—especially after the first trimester—studies show no significant increase in birth defects or long-term developmental issues in children.

Is it safe to get pregnant after having Hodgkin lymphoma?

Yes, many women go on to have healthy pregnancies after completing treatment for Hodgkin lymphoma. Doctors often recommend waiting a certain period (typically 2–5 years) after treatment ends before attempting conception, depending on the individual’s recovery and risk of relapse. Fertility preservation options should be discussed before starting treatment, as some therapies can affect ovarian function.

What signs should prompt a pregnant woman to seek medical evaluation?

Persistent or worsening symptoms such as painless swollen lymph nodes, unexplained fever, night sweats, fatigue, or weight loss should be evaluated promptly. While some symptoms can mimic normal pregnancy changes, any concern should be discussed with a healthcare provider, who may order further testing if needed.

This article is intended for informational purposes only and does not substitute for professional medical advice. Individuals facing a cancer diagnosis during pregnancy should consult with their oncology and obstetrics care teams for personalized guidance.