Study offers hope of pregnancy after stem cell transplantation

Young women facing stem cell transplants are often counseled to not expect to have children –AI generated image by Microsoft Designer

CANCER DIGEST – July 28, 2024 – A new analysis shows that women 18-35 who have been treated for cancer or other diseases with allogeneic stem cell transplantation have a good chance at of becoming pregnant and having healthy children. The study appears in the July 12, 2024 journal Blood.

“Fertility is a very important topic for young female patients,” said Katja Sockel, MD, senior physician at University Hospital Carl Gustav Carus Dresden in Germany, and lead study author. “Some patients even opt out of receiving certain treatments because of concerns about fertility. For young adult cancer survivors especially, the return to a normal life includes family planning.”

Allogeneic stem cell transplantation is often used to treat blood cancers, such as leukemia or lymphoma or other diseases, such as sickle cell anemia. It involves taking blood stem cells from a matched donor and transplanting them into the patient to replace the patient’s cancer-riddled blood and immune system. 

AlloHCT or allogeneic hematopoietic cell transplantation has led to more long-term cancer survivors especially among young adults who still hope to have children. For many years the preparation for transplantation, however, involved total body irradiation or high-dose chemotherapy regimens that often affected fertility.  Many of these women are counseled to not expect to be able to achieve pregnancy after stem cell transplantation.

In the largest study to date of adult female alloHCT recipients, Dr. Sockel’s team analyzed data from 2,654 women 18-40 years of age who had stem cell transplants between the ages of 18 and 35.

They found that despite a birthrate for these women that was six times lower compared to the general population, 72 percent reported spontaneous pregnancies. Of the 2,654 patients, 50 women reported 74 pregnancies, 57 of which resulted in live births. The median time between treatment and pregnancy was 4.7 years.

Fetal outcomes from 44 of the pregnancies showed no increases in rates of childhood illness or developmental delays compared to the general population. Ten women had preterm delivery (birth before 37 weeks of pregnancy) and as expected lower birth weight occurred among the babies of these women.

“The results of this study show that female alloHCT recipients can achieve successful and safe pregnancies,” said Dr. Sockel. “These findings help provide a basis for counseling young women of childbearing age and raising awareness of and funding for different ART techniques so that patients can have a normal life after alloHCT.”

A limitation of the study was that it relied on self-reported pregnancy, which may have led to underreporting of unsuccessful pregnancies. Additional studies will be needed to expand on the post alloHCT pregnancy experience of these women.

Source: American Society of Hematology press release