Table 5.
Review of representative large case series of pregnancy after hematopoietic-cell transplantation
| Reference | N* | Age at HCT in years, Median (range) | Age at first pregnancy in years, Median (range) | Time between HCT and pregnancy in years, Median (range) | TBI in conditioning, N (%) | Cyclophosphamide in conditioning, N (%) | Remarks |
|---|---|---|---|---|---|---|---|
| Allogeneic HCT | |||||||
| Sanders et al (1996)(13) | Women=41 | 18 (4-34) | 24 (16-36) | -- (<1-17) | 13 (32%) | 41 (100%) | - 115/146 (79%) pregnancies resulted in live births |
| - Rates of abortion and congenital abnormalities no greater than general population rates | |||||||
| - Greater than expected rates of preterm deliveries and low birth weight infants in female HCT recipients | |||||||
| - TBI increased risk of abortion | |||||||
| Men=35 | 22 (11-42) | 33 (24-52) | -- (<1-18) | 5 (14%) | 35 (100%) | ||
| Salooja et al (2001)(12) | Women=74 | 19 (6-36) | -- | 6 (<1-13) | 32 (43%) | 68 (92%) | - 271/312 (87%) pregnancies resulted in live births |
| - Rates of congenital abnormalities no greater than general population rates | |||||||
| - TBI increased risk of maternal complications in female recipients of allogeneic HCT | |||||||
| Men=93 | 25 (10-45) | -- | 5 (1-20) | 21 (23%) | 65 (70%) | ||
| Carter et al (2006)(4) | Women=4 | 22 (21-30) | 26 (23-28) | -- | 3 (75%) | 3 (75%) | - 46/54 (85%) pregnancies resulted in live births |
| - Likelihood of live birth, miscarriage and stillbirth similar to sibling controls | |||||||
| - Limited to adult HCT recipients | |||||||
| Men=18 | 27 (21-35) | 31 (25-43) | -- | 13 (72%) | 14 (78%) | ||
| Autologous HCT | |||||||
| Jackson et al (1997)(11) | Women=10 | 25 (23-36) | -- | 2 (1-6) | 0 | 0 | - 13/13 (100%) pregnancies resulted in live births |
| - All patients received melphalan ± etoposide conditioning | |||||||
| - No congenital abnormalities observed | |||||||
| - Limited to adult HCT recipients | |||||||
| Salooja et al (2001)(12) | Women=39 | 24 (18-33) | -- | 3 (<1-18) | 3 (8%) | 5 (13%) | - Salooja et al, vide supra |
| Men=26 | 27 (15-33) | -- | 4 (1-13) | 3 (12%) | 10 (39%) | ||
| Carter et al (2006)(4) | Women=4 | 27 (25-30) | 31 (29-33) | -- | 2 (50%) | 4 (100%) | - Carter et al, vide supra |
| Men=8 | 30 (23-37) | 34 (27-40) | -- | 2 (25%) | 8 (100%) |
HCT – hematopoietic-cell transplantation, TBI – total body irradiation
*
Women who reported pregnancy or men who fathered a child