Onset and outcome of pregnancy after autologous haematopoietic SCT (AHSCT) for autoimmune diseases: a retrospective study of the EBMT autoimmune diseases working party (ADWP).
Autologous haematopoietic SCT (AHSCT) is increasingly used to control severe and refractory autoimmune diseases (AD). Many patients are women of reproductive age with a potential desire for children. We present a multicentre retrospective analysis of pregnancy and childbirth in patients who underwent AHSCT for AD. The databases of the European Blood and Marrow Transplantation and University of Sao Paulo, Ribeirão Preto, Brazil were searched for female patients aged 18-50 years who had received AHSCT for AD between 1994-2011. In 324 adult female patients, 22 pregnancies were reported in 15 patients between 1997-2011. Indications for AHSCT included multiple sclerosis (n=7), systemic sclerosis (n=5), rheumatoid arthritis (n=1), juvenile idiopathic arthritis (n=1) and Takayasu disease (n=1). Of the 22 reported pregnancies, 20 followed natural conception. 15 pregnancies (68%) resulted in healthy life births, whereas 7 (32%) failed. Exacerbations of AD occurred in two patients during second pregnancies. No maternal mortality was associated with pregnancy or postpartum. There were no reports of congenital, developmental or any other disease in the children. This retrospective analysis confirms the possibility of pregnancy and childbirth following AHSCT for severe AD. The outcome of pregnancy is generally good and most led to the birth of a healthy child.
Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
E
E
Snarski
Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust & University of Sheffield, Sheffield, UK.
J A
JA
Snowden
Division of Clinical Immunology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
M C
MC
Oliveira
Division of Hematology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
B
B
Simoes
EBMT Paris Study Office, ADWP-EBMT, Hopital Saint-Antoine, Assistance Publique des Hôpitaux de Paris, UPMC Univ Paris 06, UMR-S 938, Paris, France.
M
M
Badoglio
Department of Haematology, University Hospital, Uppsala, Sweden.
K
K
Carlson
1] Department of Neurosciences, Uppsala University, Uppsala, Sweden [2] Department of Neurology, Uppsala University Hospital, Uppsala, Sweden.
J
J
Burman
The Haematology and Bone Marrow Transplant Department, St Vincent's Hospital, Sydney, NSW, Australia.
J
J
Moore
BMT Unit, Hematology Department, Hospital Clinic and Institut d'Investigació Biomèdiques August PI i Sunyer (IDIBAPS), Barcelona, Spain.
M
M
Rovira
Department of Hematology, Royal Liverpool University Hospital, Liverpool, UK.
R E
RE
Clark
Neurology Service, Hospital Clinic and Institut d'Investigació Biomèdiques August PI i Sunyer (IDIBAPS), Barcelona, Spain.
A
A
Saiz
Department of Internal Medicine, CHU Purpan, Toulouse, France.
S
S
Hadj-Khelifa
The Haematology and Bone Marrow Transplant Department, St Vincent's Hospital, Sydney, NSW, Australia.
J
J
Tan
Unità Operativa di Oncoematologia e Trapianto di Midollo, Ospedale La Maddalena, Palermo, Italy.
A
A
Crescimanno
Unità Operativa di Oncoematologia e Trapianto di Midollo, Ospedale La Maddalena, Palermo, Italy.
M
M
Musso
Strasbourg University Hospital CNRS UPR 3572, Strasbourg, France.
T
T
Martin
Internal Medicine and Vascular Disease Unit UH 04, Assistance Publique Hôpitaux de Paris, INSERM UMRS 1160, France.
D
D
Farge
D000293:Adolescent; D000328:Adult; D064592:Autografts; D016208:Databases, Factual; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D050498:Live Birth; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D012189:Retrospective Studies