Women who become pregnant after allogeneic haematopoietic cell transplants have a high chance of a successful outcome, according to a major new analysis.
Researchers, reporting in Blood, say the findings undermine a previous view that pregnancies are nearly impossible following these transplants.
The findings come from a study of women aged between 18 and 40 in the German Registry for Stem Cell Transplantation.
The study found 50 women reporting pregnancies among 2,654 patients. There were 74 pregnancies in total, with 57 live births. The median time from transplantation to first pregnancy was 4.7 years, whilst the median age for pregnancy was 29.6 years.
72% of the women said the pregnancies were spontaneous. The researchers speculate that some may have been unplanned – as the prevailing view among medical professionals was that pregnancy was not possible after allogeneic transplants.
A reduced intensity conditioning regimen, transplants for non-malignant conditions and no or lower-dose total body irradiation seemed to be linked to an improved chance of a successful first live birth. Rates of low birth weight and pre-term birth were higher in this group compared to the general population, the researchers report.
Study leader Dr Katja Sockel, of the University Hospital Carl Gustav Carus Dresden, Germany, said: “Fertility is a very important topic for young female patients. Some patients even opt out of receiving certain treatments because of concerns about fertility. For young adult cancer survivors especially, the return to a normal life includes family planning.
“Some study participants reported that they had not taken measures to prevent pregnancy because their doctor told them conception was not possible.
“These findings help provide a basis for counselling young women of childbearing age and raising awareness of and funding for different assisted reproduction techniques so that patients can have a normal life after alloHCT.”
Source:
Sockel K, Neu A, Goeckenjan M, Ditschkowski M, Hilgendorf I, Kroeger N, Ayuk FA, Stölzel F, Middeke JM, Eder M, Bethge WA, Finke J, Bertz H, Kobbe G, Kaufmann M, Platzbecker U, Beverungen D, Schmid C, von Bonin M, Egger-Heidrich K, Heberling L, Trautmann-Grill K, Teipel R, Bug G, Tischer J, Fraccaroli A, Fante MA, Wolff D, Luft T, Winkler J, Schäfer-Eckart K, Scheid C, Holtick U, Klein S, Blau I, Burchert A, Wulf GG, Hasenkamp J, Schwerdtfeger R, Kaun S, Junghanss C, Wortmann F Dr med, Winter S, Neidlinger H, Theuser C, Beyersmann J, Bornhäuser M, Schmeller S, Schetelig J. (2024) “Hope for Motherhood: Pregnancy After Allogeneic Hematopoietic Cell Transplantation - a National Multicenter Study.” Blood, 15 July 2024, doi: 10.1182/blood.2024024342.
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