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The diagnosis of lymphoma in pregnant patients poses a therapeutic challenge necessitating consideration of the developing fetus without compromise of therapy with curative potential for the mother. The decision to initiate therapy during pregnancy is heavily influenced by fetal, maternal, and disease-related factors, of which the most influential are the trimester at diagnosis, the stage, and aggressiveness of the disease and the presence of life-threatening symptoms. Recent data suggest that deferral of therapy until after the first trimester is desirable if it is perceived that postponement of therapy will not compromise maternal outcome. For some patients, delay of therapy to the postpartum period is feasible.