Christhardt Köhler1, Peter Oppelt2, Giovanni Favero3, Bernd Morgenstern4, Ingo Runnebaum5, Audrey Tsunoda6, Alexander Schmittel7, Achim Schneider8, Michael Mueller9, Simone Marnitz10. 1. Department of Advanced Gynecologic Surgery and Oncology, Asklepios Hospital Hamburg, Hamburg, Germany. Electronic address: ch.koehler@asklepios.com. 2. Department of Gynecology and Obstetrics, Women and Children Hospital Linz; and Medical Faculty of Johannes Kepler University Linz, Linz, Austria. 3. Department of Advanced Gynecologic Surgery and Oncology, Asklepios Hospital Hamburg, Hamburg, Germany. 4. Department of Gynecology, University Hospital Cologne, Cologne, Germany. 5. Department of Gynecology, University Hospital Jena, Jena, Germany. 6. Department of Gynecologic Oncology, Hospital de Cãncer de Barretos, Barretos, Brazil. 7. Ambulatory Oncologic Health Care Center Berlin Seestrasse, Berlin, Germany. 8. Institute for Cytologie and Dyplasia, Fürstenberg-Karree Berlin, Berlin, Germany. 9. Department of Gynecology, University Hospital Bern, Bern, Switzerland. 10. Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Abstract
OBJECTIVE: Cervical cancer is the most common solid cancer diagnosed in pregnancy. Platinum is an active drug in the treatment of patients with cervical cancer. In the second and third trimesters, platinum is used to prevent cancer progression until fetal maturity is reached. However, knowledge about the transplacental passage of platinum is very limited. STUDY DESIGN: Between May 2008 and June 2014, platinum-based neoadjuvant chemotherapy was applied to 21 consecutive patients with cervical cancer diagnosed in their second trimester. At the time of delivery by cesarean delivery, synchronous samples from maternal blood, umbilical cord blood, and amniotic fluid were taken and analyzed for platinum concentrations. RESULTS: The mean week of gestation at cancer diagnosis was 17 (13-23). On average 3 (range, 2-4) cycles of chemotherapy were applied. Cesarean deliveries were carried out between 30.4 and 36.5 weeks of gestation. Twenty-two healthy babies without renal, hepatic, auditory, or hematopoietic impairment were delivered. Platinum concentrations in umbilical cord blood and amniotic fluid were 23-65% and 11-42% of the maternal blood, respectively. CONCLUSION: This series on in vivo measurement of platinum concentrations in the fetomaternal compartment observed that because of consistently lower platinum values in the fetoplacental unit, a placental filtration mechanism of platinum may be assumed.
OBJECTIVE:Cervical cancer is the most common solid cancer diagnosed in pregnancy. Platinum is an active drug in the treatment of patients with cervical cancer. In the second and third trimesters, platinum is used to prevent cancer progression until fetal maturity is reached. However, knowledge about the transplacental passage of platinum is very limited. STUDY DESIGN: Between May 2008 and June 2014, platinum-based neoadjuvant chemotherapy was applied to 21 consecutive patients with cervical cancer diagnosed in their second trimester. At the time of delivery by cesarean delivery, synchronous samples from maternal blood, umbilical cord blood, and amniotic fluid were taken and analyzed for platinum concentrations. RESULTS: The mean week of gestation at cancer diagnosis was 17 (13-23). On average 3 (range, 2-4) cycles of chemotherapy were applied. Cesarean deliveries were carried out between 30.4 and 36.5 weeks of gestation. Twenty-two healthy babies without renal, hepatic, auditory, or hematopoietic impairment were delivered. Platinum concentrations in umbilical cord blood and amniotic fluid were 23-65% and 11-42% of the maternal blood, respectively. CONCLUSION: This series on in vivo measurement of platinum concentrations in the fetomaternal compartment observed that because of consistently lower platinum values in the fetoplacental unit, a placental filtration mechanism of platinum may be assumed.
Authors: Nabil Abdalla; Magdalena Bizoń; Robert Piórkowski; Paweł Stanirowski; Krzysztof Cendrowski; Włodzimierz Sawicki Journal: Biomed Res Int Date: 2017-05-24 Impact factor: 3.411