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

Autor:	Sockel K; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany., Neu A; Altona Children's Hospital, Hamburg, Germany., Goeckenjan M; Department for Gynaecology and Obstetrics, University Hospital Dresden, Technical University Dresden, Dresden, Germany., Ditschkowski M; Department of Hematology and Stem Cell Transplantation, University of Duisburg-Essen, University Hospital Essen, Essen, Germany., Hilgendorf I; Universitätsklinikum Jena, Klinik für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Jena, Germany., Kröger N; Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Ayuk FA; Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Stoelzel F; Division of Stem Cell Transplantation and Cellular Immunotherapy, Department of Internal Medicine II, University Hospital Schleswig-Holstein, Kiel, Germany., Middeke JM; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany., Eder M; Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany., Bethge W; Department of Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Germany., Finke J; Department of Hematology, Oncology, and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany., Bertz H; Department of Hematology, Oncology, and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany., Kobbe G; Department of Hematology, Oncology and Clinical Immunology, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany., Kaufmann M; 2nd Department of Internal Medicine, Oncology, and Hematology, Robert Bosch Hospital, Stuttgart, Germany., Platzbecker U; Department of Hematology, Cellular Therapy and Hemostaseology, University Hospital Leipzig, Leipzig, Germany., Beverungen D; Department of Hematology, Cellular Therapy and Hemostaseology, University Hospital Leipzig, Leipzig, Germany., Schmid C; Augsburg University Hospital and Medical Faculty and Bavarian Cancer Research Center, Augsburg, Germany., von Bonin M; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany., Egger-Heidrich K; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany., Heberling L; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany., Trautmann-Grill K; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany., Teipel R; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany., Bug G; Department of Medicine, Hematology, and Oncology, Goethe University Frankfurt, University Hospital, Frankfurt, Germany., Tischer J; Department of Medicine III, Ludwig Maximilian University, University Hospital of Munich, Munich, Germany., Fraccaroli A; Department of Medicine III, Ludwig Maximilian University, University Hospital of Munich, Munich, Germany., Fante M; Department of Internal Medicine III, Hematology, and Oncology, University Hospital Regensburg, Regensburg, Germany., Wolff D; Department of Internal Medicine III, Hematology, and Oncology, University Hospital Regensburg, Regensburg, Germany., Luft T; Department of Internal Medicine V (Hematology/Oncology/Rheumatology), Heidelberg University Hospital, Heidelberg, Germany., Winkler J; Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany., Schäfer-Eckart K; Department of Internal Medicine V, Nuremberg Hospital North, Paracelsus Medical University, Nuremberg, Germany., Scheid C; Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany., Holtick U; Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany., Klein S; Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany., Blau IW; Department of BMT, Clinic of Hematology, Oncology, and Tumor Immunology, Charite-University Medicine Berlin, Berlin, Germany., Burchert A; Department of Hematology, Oncology, and Immunology, Carreras Leukemia Center, Philips University Marburg and University Hospital Gießen and Marburg, Marburg, Germany., Wulf G; Hematology and Medical Oncology, University Medicine Göttingen, Göttingen, Germany., Hasenkamp J; Hematology and Medical Oncology, University Medicine Göttingen, Göttingen, Germany., Schwerdtfeger R; Center for Hematopoietic Cell Transplantation, Deutsche Klinik für Diagnostik Helios Klinik, Wiesbaden, Germany., Kaun S; Hematology, Oncology und Infectiology, Clinic Bremen-Mitte, Bremen, Germany., Junghanss C; Department of Medicine, Clinic III, Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany., Wortmann F; Department of Hematology and Oncology, Medical Center, University of Schleswig-Holstein, Lübeck, Germany., Winter S; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany., Neidlinger H; German Registry of Stem Cell Transplantation (DRST), Ulm, Germany., Theuser C; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany., Beyersmann J; Institute of Statistics, University Ulm, Ulm, Germany., Bornhaeuser M; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany.; German Cancer Consortium (DKTK), Partner Site Dresden, Dresden, Germany.; National Center for Tumor Diseases, Partner Site Dresden, Dresden, Germany., Schmeller S; Institute of Statistics, University Ulm, Ulm, Germany., Schetelig J; Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany.
Jazyk:	angličtina
Zdroj:	Blood [Blood] 2024 Oct 03; Vol. 144 (14), pp. 1532-1542.
DOI:	10.1182/blood.2024024342
Abstrakt:	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 Gy, 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. (© 2024 American Society of Hematology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)
Databáze:	MEDLINE
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