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Pregnancy post autologous stem cell transplant with BEAM conditioning for multiple sclerosis

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  • Pregnancy post autologous stem cell transplant with BEAM conditioning for multiple sclerosis

    Pregnancy post autologous stem cell transplant with BEAM conditioning for multiple sclerosis

    Show all authors
    Sophie Chatterton, Barbara Withers, Ian J Sutton, ...
    First Published April 19, 2021
    https://doi.org/10.1177/13524585211005660

    Abstract

    Background:
    Given the increasing numbers of multiple sclerosis (MS) patients undergoing autologous haematopoietic stem cell transplant (AHSCT) worldwide, and with women of childbearing age overrepresented in the target population, it is increasingly important to review fertility and pregnancy outcomes following AHSCT.

    Objective:
    To evaluate the rate of pregnancy and complications post-AHSCT for MS.

    Method:
    Retrospective evaluation of the rate of pregnancy and associated complications in a cohort of patients post-AHSCT with BEAM conditioning for MS since 2010 in a tertiary referral centre.

    Results:
    In our ongoing Phase 2 trial of AHSCT for MS, 55 patients have undergone AHSCT with 30 females being of childbearing age at time of transplantation. Four pregnancies occurred following AHSCT. Two pregnancies were carried to term. No maternal or neonatal complications were reported in either case. Two pregnancies were not carried to term due to elective terminations. Both of these patients became pregnant unexpectedly 2 years following AHSCT. Of the 21 male patients, one patient has fathered three children since his AHSCT. There were no newborn complications.

    Conclusions:
    This is the first report to our knowledge on fertility outcomes in both sexes post-AHSCT for MS. Patients of both sexes should be counselled prior to treatment on infertility and contraceptive use.
    Dave Bexfield
    ActiveMSers

  • #2
    Menstrual cycle resumption and female fertility after autologous hematopoietic stem cell transplantation for multiple sclerosis

    Claudia Massarotti#, Elvira Sbragia#, Giacomo Boffa, ...
    First Published March 12, 2021

    https://doi.org/10.1177/13524585211000616

    Abstract
    Data on fertility after autologous hematopoietic stem cell transplantation (aHSCT) in women with multiple sclerosis (MS) are inconclusive. This study aims to report on post-aHSCT menstrual resumption in a multi-center MS-women cohort. Out of 43 women, 30 (70%) recovered menses after a mean time of 6.8 months. Older age (odds ratio (OR) = 0.5, p < 0.0001) and previous pulsed cyclophosphamide (OR = 0.44, p = 0.005) were independently associated with a reduced menstrual recovery probability. Conditioning regimens’ intensity resulted not associated with post-procedure amenorrhea. Our results highlight younger age as significantly associated with menses recovery; proper fertility counseling for MS women candidated to aHSCT both prior- and post-transplantation is therefore warranted.
    Dave Bexfield
    ActiveMSers

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