Table 1.

Characteristics of an ideal multidisciplinary team treating the pregnant patient with concomitant Hodgkin lymphoma

Obstetrician	■Usually makes the diagnosis, referral to heme/onc ■Brings experience in high-risk pregnancies (patients with active malignancy) ■Provides counseling regarding pregnancy termination (if recommended by the team) ■Establishes the timing and method of delivery ■Supervises effective postpartum contraception for a minimum of 2 years (greatest risk of relapse)
Hematologist/medical oncologist	■ Performs oncologic history and physical and plans staging ○ History searching for B symptoms or other symptomatic problems suggesting more advanced disease ○ Physical examination for lymphadenopathy or organomegaly ○ Complete blood cell counts ○ Serum creatinine, alkaline phosphatase, lactate dehydrogenase, bilirubin and protein electrophoresis (including albumin level) ○ Chest radiograph, PA view only, with appropriate shielding ○ Abdominal ultrasound for retroperitoneal lymphadenopathy ■Formulates therapeutic plan ■Administers chemotherapy if deemed necessary ■Provides supportive care for patients treated with chemotherapy to keep Hgb ≥100 g/L and platelet count ≥30×109/L, and reviews safety of medications used for supportive care during pregnancy ■Coordinates delivery planning and chemotherapy administration to ensure that platelet count is ≥50×109/L at the time of delivery ■Arranges oncology follow-up after pregnancy to complete appropriate staging
Neonatologist	■Has experience in high-risk pregnancies ■Has experience in childhood hematologic disorders ■Examines placenta and arranges histopathologic evaluation for presence of metastasis ■Coordinates newborn care at time of delivery ■Delivers early post-natal care of newborn ■Registers newborn to central registry of children born to pregnant mothers with HL ■Counsels about breastfeeding ■Schedules long term follow-up of newborn
Nurse coordinator	■Coordinates communication among subspecialists ■Helps interpret complex communication with the patient