Hope for motherhood: pregnancy after allogeneic hematopoietic cell transplantation (a national multicenter study)

Sockel K, Neu A, Goeckenjan M, Ditschkowski M, Hilgendorf I, Kröger N, Ayuk FA, Stölzel F, Middeke JM, Eder M, Bethge W, Finke J, Bertz H, Kobbe G, Kaufmann M, Platzbecker U, Beverungen D, Schmid C, von Bonin M, Egger-Heidrich K, Heberling L, Trautmann-Grill K, Teipel R, Bug G, Tischer J, Fraccaroli A, Fante M, Wolff D, Luft T, Winkler J, Schäfer-Eckart K, Scheid C, Holtick U, Klein S, Blau I, Burchert A, Wulf G, Hasenkamp J, Schwerdtfeger R, Kaun S, Junghanss C, Wortmann F, Winter S, Neidlinger H, Theuser C, Beyersmann J, Bornhaeuser M, Schmeller S, Schetelig J (2024)

Publication Language: English

Publication Type: Journal article

Publication year: 2024

Journal

DOI: 10.1182/blood.2024024342

Abstract

Improved long-term survival rates after allogeneic hematopoietic cell transplantation (alloHCT) make family planning for young adult cancer survivors an important topic. However, treatment-related infertility risk poses challenges. To assess pregnancy and birth rates in a contemporary cohort, we conducted a national multicenter study using data from the German Transplant Registry, focusing on adult women aged 18 to 40 years who underwent alloHCT between 2003 and 2018. Of 2654 women who underwent transplantation, 50 women experienced 74 pregnancies, occurring at a median of 4.7 years after transplant. Fifty-seven of these resulted in live births (77%). The annual first birth rate among HCT recipients was 0.45%, which is >6 times lower than in the general population. The probability of a live birth 10 years after HCT was 3.4%. Factors associated with an increased likelihood of pregnancy were younger age at alloHCT, nonmalignant transplant indications, no total body irradiation or a cumulative dose of <8 Gray, and nonmyeloablative/reduced-intensity conditioning. Notably, 72% of pregnancies occurred spontaneously, with assisted reproductive technologies used in the remaining cases. Preterm delivery and low birth weight were more common than in the general population. This study represents the largest data set reporting pregnancies in a cohort of adult female alloHCT recipients. Our findings underscore a meaningful chance of pregnancy in alloHCT recipients. Assisted reproductive technologies techniques are important and funding should be made available. However, the potential for spontaneous pregnancies should not be underestimated, and patients should be informed of the possibility of unexpected pregnancy despite reduced fertility. Further research is warranted to understand the impact of conditioning decisions on fertility preservation.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsklinikum Essen Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Robert-Bosch-Krankenhaus Germany (DE) Universitätsklinikum Düsseldorf Germany (DE) Universitätsklinikum Leipzig Germany (DE) Universität Augsburg Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Universitätsklinikum Mannheim Germany (DE) Deutsche Klinik für Diagnostik Germany (DE) Deutsches Register für Stammzelltransplantationen e.V. (DRST) Germany (DE) Universitätsmedizin Rostock Germany (DE) Klinikum Nürnberg Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Universitätsklinikum Regensburg Germany (DE) Universitätsklinikum Köln Germany (DE) Albert-Ludwigs-Universität Freiburg Germany (DE) Universitätsklinikum Tübingen Germany (DE) Klinikum der Universität München Germany (DE) Universitätsklinikum Göttingen Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Altonaer Kinderkrankenhaus (AKK) Germany (DE) Universitätsklinikum Jena Germany (DE) Universität Ulm Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE) Klinikverbund Bremen (Gesundheit Nord) Germany (DE)

How to cite

APA:

Sockel, K., Neu, A., Goeckenjan, M., Ditschkowski, M., Hilgendorf, I., Kröger, N.,... Schetelig, J. (2024). Hope for motherhood: pregnancy after allogeneic hematopoietic cell transplantation (a national multicenter study). Blood. https://doi.org/10.1182/blood.2024024342

MLA:

Sockel, Katja, et al. "Hope for motherhood: pregnancy after allogeneic hematopoietic cell transplantation (a national multicenter study)." Blood (2024).

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