A Preliminary Online Study on Menstruation Recovery in Women After Autologous Hematopoietic Stem Cell Transplant for Autoimmune Diseases.
OBJECTIVE
Autologous hematopoietic stem cell transplant has become a successful treatment option in aggressive autoimmune diseases. Young women who are consulted before this treatment are faced with an absence of data on the transplant's effect on their fertility. The aim of our study was to analyze information on menstruation recovery after autologous hematopoietic stem cell transplant for autoimmune diseases.


METHODS
An anonymous online questionnaire was distributed among members of an international Web forum of patients who had autologous hematopoietic stem cell transplant for autoimmune disease. Data were collated and analyzed.


RESULTS
We obtained responses from 28 female patients to the questionnaire. The conditioning regimens used in this population were cyclophosphamide ± antibodies or BCNU (carmustine), etoposide, Ara-C (cytarabine), and melphalan chemotherapy. All patients who were transplanted at the age of 32 years or younger showed restored menstruation after an average (standard deviation) of 5.38 months (5.34 mo). In patients aged 33 to 41 years, menstruation was restored in 38%. We found that 73% of patients already had children before autologous hematopoietic stem cell transplant, and only 15% of responders declared desire for pregnancy after transplant.


CONCLUSIONS
Our online analysis showed feasibility as a questionnaire for assessing fertility after autologous hematopoietic stem cell transplant. The results show that menstruation is restored in all patients of 32 years of age or younger, regardless of the conditioning regimen. Many of these women are likely to maintain fertility and may eventually become pregnant. However, a significant number of responders who underwent autologous hematopoietic stem cell transplant for autoimmune diseases already had children before transplant and indicated no desire for pregnancy after transplant; the data on pregnancy occurrence in this group should be interpreted in this context.
From the Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
Martyna
M
Maciejewska
Emilian
E
Snarski
Wiesław
W
Wiktor-Jędrzejczak
D000328:Adult; D001327:Autoimmune Diseases / Q000150:complications / Q000628:therapy; D005260:Female; D005298:Fertility; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008599:Menstruation Disturbances / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D011247:Pregnancy; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D055815:Young Adult