PMID- 18462010
OWN - NLM
STAT- MEDLINE
DCOM- 20090508
LR  - 20220408
IS  - 1093-5266 (Print)
IS  - 1093-5266 (Linking)
VI  - 12
IP  - 1
DP  - 2009 Jan-Feb
TI  - Effects of chemotherapy during pregnancy on the placenta.
PG  - 35-41
LID - 10.2350/08-03-0435.1 [doi]
AB  - Whereas the effects of chemotherapy during pregnancy for mother and fetus are 
      well described, its effects on the placenta remain largely undetermined. We 
      performed a retrospective clinicopathologic analysis of the placenta following 
      chemotherapy. Charts were reviewed for type of malignancy, type and timing of 
      chemotherapy, and fetal and pregnancy outcome. Placentas were studied by standard 
      pathologic analysis as well as computer-assisted morphometry and fluorescence in 
      situ hybridization (FISH) analysis. Patients (n = 13) underwent chemotherapy 
      during pregnancy for carcinoma of breast (3), ovary (2), cervix (2), salivary 
      gland (1), lymphoma/leukemia (4), or rhabdomyosarcoma (1). Eleven patients were 
      treated with DNA-active cytotoxic agents during the 2nd and/or 3rd trimesters; 
      their placentas showed nonspecific findings, including villous hypermaturity, 
      distal villous hypoplasia, villous edema, and excessive extravillous trophoblast, 
      and 4/11 (36%) were small-for-age. In one case (rhabdomyosarcoma), the mother was 
      exposed to cytotoxic agents throughout the entire pregnancy. In this case, 
      associated with severe congenital anomalies, the placenta showed striking nuclear 
      pleomorphism of the extravillous trophoblast of the chorion laeve, associated 
      with FISH-demonstrated hyperpolyploidy. One patient was treated with the targeted 
      tyrosine kinase inhibitor, imatinib, in 2 consecutive pregnancies; these 
      placentas showed no specific anomalies. Our findings suggest that chemotherapy 
      during the 1st trimester induces excessive polyploidization of the chorion laeve 
      trophoblast, likely representing an adaptive response to intraamniotic toxins. 
      Second and 3rd trimester exposure to cytotoxic agents may predispose to placental 
      underdevelopment. However, without appropriate controls (untreated patients with 
      equivalent malignancies), the specific effects of chemotherapy in this group are 
      difficult to assess.
FAU - Abellar, Rosanna G
AU  - Abellar RG
AD  - Department of Pathology, Women and Infants Hospital, Providence, RI, USA.
FAU - Pepperell, John R
AU  - Pepperell JR
FAU - Greco, David
AU  - Greco D
FAU - Gundogan, Fusun
AU  - Gundogan F
FAU - Kostadinov, Stefan
AU  - Kostadinov S
FAU - Schwartz, Joanna
AU  - Schwartz J
FAU - Tantravahi, Umadevi
AU  - Tantravahi U
FAU - De Paepe, Monique E
AU  - De Paepe ME
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pediatr Dev Pathol
JT  - Pediatric and developmental pathology : the official journal of the Society for 
      Pediatric Pathology and the Paediatric Pathology Society
JID - 9809673
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Abnormalities, Multiple/chemically induced
MH  - Adolescent
MH  - Adult
MH  - Antineoplastic Agents/*adverse effects
MH  - Female
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Infant, Newborn
MH  - Placenta/*drug effects/*pathology
MH  - Pregnancy
MH  - Pregnancy Complications, Neoplastic/*drug therapy
MH  - Pregnancy Trimester, First
MH  - Pregnancy Trimester, Second
MH  - Pregnancy Trimester, Third
MH  - Retrospective Studies
EDAT- 2008/05/09 09:00
MHDA- 2009/05/09 09:00
CRDT- 2008/05/09 09:00
PHST- 2008/03/14 00:00 [received]
PHST- 2008/05/05 00:00 [accepted]
PHST- 2008/05/09 09:00 [pubmed]
PHST- 2009/05/09 09:00 [medline]
PHST- 2008/05/09 09:00 [entrez]
AID - 08-03-0435 [pii]
AID - 10.2350/08-03-0435.1 [doi]
PST - ppublish
SO  - Pediatr Dev Pathol. 2009 Jan-Feb;12(1):35-41. doi: 10.2350/08-03-0435.1.