News | New Hope for Pregnancy After Allogeneic Stem Cell Transplantation
August 5, 2024 — A new nationwide multicenter study offers hope to women who have undergone allogeneic hematopoietic stem cell transplantation (alloHCT). Recently published in Blood, the findings show that successful pregnancy is possible under certain conditions, particularly for younger women, patients with nonmalignant diseases, and those who received no or low-dose total-body irradiation (TBI).
For many nonmalignant blood disorders, alloHCT is the only curative treatment. Advances in transplantation and optimized supportive care have steadily increased the number of long-term survivors. Family planning is particularly important to many young cancer survivors, but treatment-related infertility risk is high after alloHCT. Although pregnancies have occasionally been reported, systematic data on pregnancy and birth rates among female transplant recipients are lacking. A large nationwide German project, “Documentation of Pregnancy After Allogeneic Hematopoietic Stem Cell Transplantation,” was therefore conducted jointly by Medical Department I and the Fertility Center at University Hospital Dresden.
Key Findings:
From 2003 to 2018, 2,654 women of reproductive age in Germany underwent alloHCT. Pregnancies were recorded in 50 women, some of whom became pregnant more than once, for a total of 74 pregnancies.
Most pregnancies were successful, resulting in 57 live births.
Transplantation at a younger age, transplantation for nonmalignant disease, reduced-intensity conditioning, and low-dose (<8 Gray) TBI were associated with a greater chance of pregnancy.
Notably, up to 77% of pregnancies occurred naturally; the remainder involved assisted reproductive technology (ART).
Preterm birth and low birth weight were more common than in the general population.
Lead author Dr. Katja Sockel emphasized that the data provide an important basis for routine medical counseling of young alloHCT patients who hope to have children and valuable insight for further optimizing individualized treatment.
Professor D. Michael Albrecht, director of obstetrics and gynecology at University Hospital Dresden, said: “Optimal treatment is always linked to patient satisfaction. These findings will allow us to optimize treatment strategies and sustainably improve patients' quality of life and family planning.”
Conclusion:
This study represents the largest dataset to date on pregnancy among adult female alloHCT recipients and shows that successful pregnancy remains a realistic hope despite intensive treatment and health challenges. Early interdisciplinary collaboration is needed to plan fertility-preservation measures, such as the cooperation between NCT/UCC Dresden and the gynecology and obstetrics fertility center. Professor Esther Troost, dean of the medical faculty and a radiation oncologist, emphasized: “These data bring us closer to achieving excellent cancer outcomes while improving quality of life.”
Professor Martin Bornhäuser, managing director of NCT/UCC Dresden, added: “Young patients with cancer and survivors are a group with specific needs. Restoring a normal quality of life after cancer is a key goal. Findings like these give us important information to improve treatment strategies and reduce long-term toxicity.”
To meet the specific needs of young adults with cancer, the university hospital also supports interdisciplinary collaborations such as a transition clinic. There, pediatric oncology led by Professor Schewe and Medical Department I led by Professor Bornhäuser jointly provide long-term follow-up for adolescents and young adults after cancer.
News | New Hope for Pregnancy After Allogeneic Stem Cell Transplantation
News | New Hope for Pregnancy After Allogeneic Stem Cell Transplantation
August 5, 2024 — A new nationwide multicenter study offers hope to women who have undergone allogeneic hematopoietic stem cell transplantation (alloHCT). Recently published in Blood, the findings show that successful pregnancy is possible under certain conditions, particularly for younger women, patients with nonmalignant diseases, and those who received no or low-dose total-body irradiation (TBI).
For many nonmalignant blood disorders, alloHCT is the only curative treatment. Advances in transplantation and optimized supportive care have steadily increased the number of long-term survivors. Family planning is particularly important to many young cancer survivors, but treatment-related infertility risk is high after alloHCT. Although pregnancies have occasionally been reported, systematic data on pregnancy and birth rates among female transplant recipients are lacking. A large nationwide German project, “Documentation of Pregnancy After Allogeneic Hematopoietic Stem Cell Transplantation,” was therefore conducted jointly by Medical Department I and the Fertility Center at University Hospital Dresden.
Key Findings:
From 2003 to 2018, 2,654 women of reproductive age in Germany underwent alloHCT. Pregnancies were recorded in 50 women, some of whom became pregnant more than once, for a total of 74 pregnancies.
Most pregnancies were successful, resulting in 57 live births.
Transplantation at a younger age, transplantation for nonmalignant disease, reduced-intensity conditioning, and low-dose (<8 Gray) TBI were associated with a greater chance of pregnancy.
Notably, up to 77% of pregnancies occurred naturally; the remainder involved assisted reproductive technology (ART).
Preterm birth and low birth weight were more common than in the general population.
Lead author Dr. Katja Sockel emphasized that the data provide an important basis for routine medical counseling of young alloHCT patients who hope to have children and valuable insight for further optimizing individualized treatment.
Professor D. Michael Albrecht, director of obstetrics and gynecology at University Hospital Dresden, said: “Optimal treatment is always linked to patient satisfaction. These findings will allow us to optimize treatment strategies and sustainably improve patients' quality of life and family planning.”
Conclusion:
This study represents the largest dataset to date on pregnancy among adult female alloHCT recipients and shows that successful pregnancy remains a realistic hope despite intensive treatment and health challenges. Early interdisciplinary collaboration is needed to plan fertility-preservation measures, such as the cooperation between NCT/UCC Dresden and the gynecology and obstetrics fertility center. Professor Esther Troost, dean of the medical faculty and a radiation oncologist, emphasized: “These data bring us closer to achieving excellent cancer outcomes while improving quality of life.”
Professor Martin Bornhäuser, managing director of NCT/UCC Dresden, added: “Young patients with cancer and survivors are a group with specific needs. Restoring a normal quality of life after cancer is a key goal. Findings like these give us important information to improve treatment strategies and reduce long-term toxicity.”
To meet the specific needs of young adults with cancer, the university hospital also supports interdisciplinary collaborations such as a transition clinic. There, pediatric oncology led by Professor Schewe and Medical Department I led by Professor Bornhäuser jointly provide long-term follow-up for adolescents and young adults after cancer.
Source:
Collected online