Pregnancy after hematopoietic cell transplantation: a report from the late effects working committee of the Center for International Blood and Marrow Transplant Research (CIBMTR).
Preservation of fertility after hematopoietic cell transplantation (HCT) can have a significant influence on the quality of life of transplant survivors. We describe 178 pregnancies in HCT recipients that were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) between 2002 and 2007. There were 83 pregnancies in female HCT recipients and 95 pregnancies in female partners of male HCT recipients. Indications for transplantation included hematologic and other malignancies (N = 99) and nonmalignant disorders (N = 79, of which 75 patients had severe aplastic anemia). The cohort included recipients of autologous HCT (20 women, 13 men), myeloablative (MA) allogeneic HCT (12 women, 50 men), and nonmyeloablative allogeneic HCT (2 women, 2 men). Age at HCT was <20 years for 50% of women and 19% of men. Conditioning regimens included total body irradiation (TBI) in 16% of women and 19% of men; doses were MA in 10% of women and in 16% of men. Live births were reported in 86% of pregnancies in partners of male transplant patients and 85% of pregnancies in female transplant patients, with most pregnancies occurring 5 to 10 years after HCT. We conclude that some HCT recipients can retain fertility, including patients who have received TBI and/or MA conditioning. Young patients undergoing HCT should be counseled both before and after HCT about potential loss of fertility, methods for preserving fertility, and planning for future pregnancy. Fertility and outcomes of pregnancy after HCT need prospective evaluation in large transplant cohorts.
Loren
Alison W
AW
Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Chow
Eric
E
Jacobsohn
David A
DA
Gilleece
Maria
M
Halter
Joerg
J
Joshi
Sarita
S
Wang
Zhiwei
Z
Sobocinski
Kathleen A
KA
Gupta
Vikas
V
Hale
Gregory A
GA
Marks
David I
DI
Stadtmauer
Edward A
EA
Apperley
Jane
J
Cahn
Jean-Yves
JY
Schouten
Harry C
HC
Lazarus
Hillard M
HM
Savani
Bipin N
BN
McCarthy
Philip L
PL
Jakubowski
Ann A
AA
Kamani
Naynesh R
NR
Hayes-Lattin
Brandon
B
Maziarz
Richard T
RT
Warwick
Anne B
AB
Sorror
Mohamed L
ML
Bolwell
Brian J
BJ
Socié
Gerard
G
Wingard
John R
JR
Rizzo
J Douglas
JD
Majhail
Navneet S
NS
D000328:Adult; D000375:Aging; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007246:Infertility / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011788:Quality of Life; D012747:Sexual Partners; D019172:Transplantation Conditioning; D055815:Young Adult