Recent research from Germany challenges previous assumptions about pregnancy outcomes in women who have undergone stem cell treatments for blood cancers or sickle cell disease. Contrary to conventional wisdom, which often suggests that pregnancy may be risky or impossible post-treatment, the study indicates that successful pregnancies are achievable.
Dr. Katja Sockel, a senior physician at University Hospital Carl Gustav Carus Dresden and lead author of the study published in the journal Blood on July 15, highlighted the findings. The study, the largest of its kind involving adult female recipients of allogeneic hematopoietic cell transplantation (alloHCT), examined data from 2,654 women aged 18 to 40 who had undergone the procedure.
AlloHCT involves transplanting stem cells from a healthy donor to treat conditions like blood cancers. Despite potential risks such as long-term use of immune-suppressing medications and prior exposure to radiation or chemotherapy, the study found encouraging results regarding fertility and pregnancy.
Out of the 2,654 women studied, 50 reported a total of 74 pregnancies, resulting in 57 live births. The median time from transplantation to the first pregnancy was approximately 4.7 years. Notably, pregnancies were more common among women aged 18 to 35 at the time of transplant, occurring at an average age of just under 30.
While pregnancy rates were lower compared to the general population, most pregnancies (72%) occurred spontaneously without the need for fertility treatments. This challenges previous assumptions that conception may not be possible post-alloHCT.
Dr. Sockel emphasized the importance of educating patients about potential fertility restoration following alloHCT to prevent unintended pregnancies. She also noted that certain factors, such as less intense conditioning regimens and transplant for nonmalignant conditions, were associated with higher odds of pregnancy.
Despite the positive findings, pregnancies among these women did involve some complications, including vascular issues like preeclampsia, edema, and hypertension. However, the rates of these complications did not exceed those found in the general population.
The study underscores the need for close monitoring by transplant physicians and gynecologists during pregnancies involving alloHCT recipients. While there were increased odds of premature delivery and low birth weight, the overall message is one of hope and possibility for women seeking to start a family post-treatment.
For more information on managing pregnancies after stem cell transplantation, healthcare providers are encouraged to stay informed and engaged in ongoing research in this field.
