A new study from University Hospital Carl Gustav Carus, Dresden, Germany, has shed light on the viability of pregnancy following hematopoietic stem cell transplantation (HCT) . Led by Katja Sockel, this team aimed to better understand the pregnancy rates following allogeneic hematopoietic stem cell transplantation within the German population, as well as identify potential risk factors.
A national, multicenter study was conducted, comprising data from the German Transplant Registry. It focused on women aged 18-40 who underwent allogeneic hematopoietic cell transplantation (alloHCT) between the years of 2003-2018. From 2,654 transplanted women, 50 has experienced 74 pregnancies occurring at a median of 4.7 years post-transplant (range 0.7-14.8 years, IQR: 4.3), and the median age for pregnancy was 29.6 years. Furthermore, of the 74 pregnancies, 57 (77%) resulted in live births. The annual first birth rate among hematopoietic stem cell recipients was 0.45% (95% CI: 0.31-0.59%). Although this birth rate is almost six times lower than the general population, the results still show that successful pregnancies are still possible among female alloHCT recipients.
Researchers noted the following factors increased the likelihood of pregnancy; Lower age at alloHCT (<35 years), NMA/RIC conditioning, lower TBI doses <8 Gray and non-malignant transplant indications. Sockel et al recommended that fertility counselling before HCT be provided to every woman of childbearing age, not only to discuss fertility preservation techniques but also to inform patients about the potential for natural fertility restoration after HCT to prevent unexpected pregnancies.
‘In this large national multi-centre study evaluating pregnancy and live birth rates after alloHCT, we demonstrate that female HCT recipients can achieve successful and safe pregnancies, despite facing various fertility risks during treatment’ concluded the primary author, Sockel.
Helena Bradbury, EMJ
Reference
Sockel K et al. Hope for Motherhood: Pregnancy After Allogeneic Hematopoietic Cell Transplantation – a National Multicenter Study. Blood. 2024;DOI:10.1182/blood.2024024342
