Prevention and management of infectious diseases in pregnant women with haematological malignancies

Sébastien Gaultier¹, Asmaa Tazi², Caroline Charre³, André Paugam⁴, Laurent Chouchana⁵, Sihem Benaboud⁶, Marie Lachâtre⁷, Olivier Baud⁸, Catherine Fischer⁹, Pauline Richebé⁷, Etienne Canouï⁷, Olivia Anselem¹⁰, Fanny Vuotto¹¹, Justine Decroocq¹², Vassilis Tsatsaris¹³, Didier Bouscary¹², Rudy Birsen¹², Caroline Charlier¹⁴

Affiliations

¹ Department of Infectious Diseases, Cochin Port Royal University Hospital, AP-HP, Paris, France; Department of Clinical Haematology, Cochin Port Royal University Hospital, AP-HP, Paris, France; HeMaPreg Network, Paris, France.
² HeMaPreg Network, Paris, France; Microbiology Department, French National Reference Centre for Streptococci, Cochin Port Royal University Hospital, AP-HP, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France; Institut Cochin, Inserm U1016, CNRS UMR8104, Paris, France.
³ FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France; Virology Department, Cochin Port Royal University Hospital, AP-HP, Paris, France.
⁴ Microbiology Department, French National Reference Centre for Streptococci, Cochin Port Royal University Hospital, AP-HP, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France.
⁵ HeMaPreg Network, Paris, France; Regional Pharmacovigilance Center, Department of perinatal paediatrics and adult Pharmacology, Cochin Port Royal University Hospital, AP-HP, Paris, France; UMR1343 INSERM Pharmacology and Therapeutic Evaluation in Children and Pregnant Women, Paris, France.
⁶ Université Paris Cité, Paris, France; Regional Pharmacovigilance Center, Department of perinatal paediatrics and adult Pharmacology, Cochin Port Royal University Hospital, AP-HP, Paris, France; UMR1343 INSERM Pharmacology and Therapeutic Evaluation in Children and Pregnant Women, Paris, France.
⁷ Department of Infectious Diseases, Cochin Port Royal University Hospital, AP-HP, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France.
⁸ FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France; Department of Neonatology, Cochin Port Royal University Hospital, AP-HP, Paris, France.
⁹ Department of Anaesthesiology, Cochin Port Royal University Hospital, AP-HP, Paris, France.
¹⁰ HeMaPreg Network, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France; Obstetrics and Gynaecology, Cochin Port Royal University Hospital, AP-HP, Paris, France.
¹¹ Department of Infectious diseases, Huriez University hospital, Lille, France.
¹² Department of Clinical Haematology, Cochin Port Royal University Hospital, AP-HP, Paris, France; HeMaPreg Network, Paris, France; Université Paris Cité, Paris, France.
¹³ HeMaPreg Network, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France; Institut Cochin, Inserm U1016, CNRS UMR8104, Paris, France; Obstetrics and Gynaecology, Cochin Port Royal University Hospital, AP-HP, Paris, France; Institut Santé des Femmes, Université Paris Cité, Paris, France.
¹⁴ Department of Infectious Diseases, Cochin Port Royal University Hospital, AP-HP, Paris, France; HeMaPreg Network, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France; National Reference Center for Listeriosis, Biology of Infection Unit, INSERM U1155, Institut Pasteur, Paris, France. Electronic address: caroline.charlier@aphp.fr.

PMID: 40744046
DOI: 10.1016/S2352-3026(25)00165-6

Review

Prevention and management of infectious diseases in pregnant women with haematological malignancies

Sébastien Gaultier et al. Lancet Haematol. 2025.

. 2025 Jul 28:S2352-3026(25)00165-6.

doi: 10.1016/S2352-3026(25)00165-6. Online ahead of print.

Authors

Affiliations

¹ Department of Infectious Diseases, Cochin Port Royal University Hospital, AP-HP, Paris, France; Department of Clinical Haematology, Cochin Port Royal University Hospital, AP-HP, Paris, France; HeMaPreg Network, Paris, France.
² HeMaPreg Network, Paris, France; Microbiology Department, French National Reference Centre for Streptococci, Cochin Port Royal University Hospital, AP-HP, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France; Institut Cochin, Inserm U1016, CNRS UMR8104, Paris, France.
³ FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France; Virology Department, Cochin Port Royal University Hospital, AP-HP, Paris, France.
⁴ Microbiology Department, French National Reference Centre for Streptococci, Cochin Port Royal University Hospital, AP-HP, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France.
⁵ HeMaPreg Network, Paris, France; Regional Pharmacovigilance Center, Department of perinatal paediatrics and adult Pharmacology, Cochin Port Royal University Hospital, AP-HP, Paris, France; UMR1343 INSERM Pharmacology and Therapeutic Evaluation in Children and Pregnant Women, Paris, France.
⁶ Université Paris Cité, Paris, France; Regional Pharmacovigilance Center, Department of perinatal paediatrics and adult Pharmacology, Cochin Port Royal University Hospital, AP-HP, Paris, France; UMR1343 INSERM Pharmacology and Therapeutic Evaluation in Children and Pregnant Women, Paris, France.
⁷ Department of Infectious Diseases, Cochin Port Royal University Hospital, AP-HP, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France.
⁸ FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France; Department of Neonatology, Cochin Port Royal University Hospital, AP-HP, Paris, France.
⁹ Department of Anaesthesiology, Cochin Port Royal University Hospital, AP-HP, Paris, France.
¹⁰ HeMaPreg Network, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France; Obstetrics and Gynaecology, Cochin Port Royal University Hospital, AP-HP, Paris, France.
¹¹ Department of Infectious diseases, Huriez University hospital, Lille, France.
¹² Department of Clinical Haematology, Cochin Port Royal University Hospital, AP-HP, Paris, France; HeMaPreg Network, Paris, France; Université Paris Cité, Paris, France.
¹³ HeMaPreg Network, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France; Institut Cochin, Inserm U1016, CNRS UMR8104, Paris, France; Obstetrics and Gynaecology, Cochin Port Royal University Hospital, AP-HP, Paris, France; Institut Santé des Femmes, Université Paris Cité, Paris, France.
¹⁴ Department of Infectious Diseases, Cochin Port Royal University Hospital, AP-HP, Paris, France; HeMaPreg Network, Paris, France; FHU Prem'IMPACT, AP-HP, Paris, France; Université Paris Cité, Paris, France; National Reference Center for Listeriosis, Biology of Infection Unit, INSERM U1155, Institut Pasteur, Paris, France. Electronic address: caroline.charlier@aphp.fr.

PMID: 40744046
DOI: 10.1016/S2352-3026(25)00165-6

Abstract

The incidence of haematological malignancies during pregnancy ranges from 4·0 to 15·8 cases per 100 000 pregnancies, with Hodgkin lymphoma, acute leukaemia, and aggressive B-cell non-Hodgkin lymphoma being the most frequent subtypes. Although survival rates are similar to those in patients who are not pregnant with similar disease profiles, pregnant women face higher risks of maternal morbidity, along with adverse obstetric and neonatal outcomes. Their management, therefore, requires a carefully balanced approach that minimises obstetric risks and ensures effective oncological control. Physiological adaptations of pregnancy can obscure the clinical presentation of sepsis, modulate the course of infections, and, through altered pharmacokinetics, complicate antimicrobial therapy. Safety data on antimicrobials are scarce and concerns about teratogenicity further constrain therapeutic decisions. As a result, infection management in pregnant women requires tailored approaches to diagnosis, antimicrobial therapy, and fetal monitoring. This Review summarises the physiological changes influencing infection risk and treatment efficacy in pregnant women with haematological malignancies; it outlines key challenges in prevention and management and identifies crucial knowledge gaps to guide practice and research in this complex interplay.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests CCharl declares consulting fees from Pfizer, honoraria for presentations from Pfizer and Mundipharma, and research support from Amivas. RB declares consulting fees from Bristol Myers Squibb, honoraria for presentations form Jazz Pharma and Servier, and support for attending meetings from Sandoz. CCharr has received honoraria and travel grants from Merck Sharp and Dohme, ViiV Healthcare, and Gilead Sciences for participation in educational programmes and conferences. All other authors declare no competing interests.

Publication types

Actions

LinkOut - more resources

Full Text Sources
- ClinicalKey
- Elsevier Science
Research Materials
- NCI CPTC Antibody Characterization Program

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Prevention and management of infectious diseases in pregnant women with haematological malignancies

Affiliations

Prevention and management of infectious diseases in pregnant women with haematological malignancies

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

LinkOut - more resources

Full Text Sources

Research Materials