Pregnancy after Hematopoietic Cell Transplantation: A Report from the Late Effects Working Committee of the Center for International Blood and Marrow Transplant Research (CIBMTR)

Alison W. Loren, Eric Chow, David A. Jacobsohn, Maria Gilleece, Joerg Halter, Sarita Joshi, Zhiwei Wang, Kathleen A. Sobocinski, Vikas Gupta, Gregory A. Hale, David I. Marks, Edward A. Stadtmauer, Jane Apperley, Jean Yves Cahn, Harry C. Schouten, Hillard M. Lazarus, Bipin N. Savani, Philip L. McCarthy, Ann A. Jakubowski, Naynesh R. KamaniBrandon Hayes-Lattin, Richard T. Maziarz, Anne B. Warwick, Mohamed L. Sorror, Brian J. Bolwell, Gerard Socié, John R. Wingard, J. Douglas Rizzo, Navneet S. Majhail

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)157-166
Number of pages10
JournalBiology of Blood and Marrow Transplantation
Volume17
Issue number2
DOIs
StatePublished - Feb 2011

Keywords

  • Allogeneic hematopoietic cell transplantation
  • Autologous hematopoietic cell transplantation
  • Fertility preservation
  • Pregnancy

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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