Pregnancy outcomes in female cancer survivors after hematopoietic stem cell transplantation

D. İskender, M. İbanoğlu, S. Seçilmiş, N.A. Baysal, M.K. Çakar, M.S. Dal, B.U. Ulu, S.Y. Ergani, A. Kaymak, T.T. İlhan, S. Başçı, T.N. Yiğenoğlu, C. İskender, F. Altuntaş

Department of Haematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey. drmujdecan@gmail.com

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• Hematology
• Obstetrics
• Oncology

OBJECTIVE: This study was conducted to retrospectively investigate the pregnancy outcomes of patients who underwent stem cell transplantation (SCT). We also aimed at determining the reasons for avoiding pregnancy despite prolonged remission.

PATIENTS AND METHODS: The study population consisted of patients who became pregnant after autologous or allogeneic SCT at Dr. Abdurrahman Yurtarslan Oncology Hospital between 2009 and 2020 for hematologic diseases. Data from 83 patients who had undergone allogeneic or autologous SCT were available for analysis. A total of 18 pregnancies occurred in 14 of these patients. To compare pregnancy outcomes, pregnant patients who received care at Etlik Zübeyde Hanım Maternity Hospital were selected as the control group.

RESULTS: No pregnancy occurred in 69 of the patients whose data were analyzed. Of these 69 patients, 48 (69.6%) did not want to become pregnant. The most common reason for not wanting a pregnancy was due to the fact that the patient was not married [21 patients (30.4%)]. The pregnancy rate was higher in the HL group than in other hematologic malignancies [8 patients (57.1%)]. Twelve (85.7%) of the patients who became pregnant did so after autologous SCT and 2 (14.3%) after allogeneic SCT. The cumulative incidence of obstetric complications was higher in pregnancies after SCT than in the control group, and the prevalence of low birth weight was observed more frequently.

CONCLUSIONS: Patients who became pregnant after SCT have a higher rate of pregnancy complications. However, these patients achieve similar live birth rates as the healthy population. Many patients have concerns about pregnancy and should be counseled appropriately.

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