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Autoimmune Disorders

Onset and outcome of pregnancy after autologous haematopoietic SCT (AHSCT) for autoimmune diseases: a retrospective study of the EBMT autoimmune diseases working party (ADWP)

Bone Marrow Transplantation volume 50, pages 216–220 (2015)Cite this article

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Abstract

Autologous haematopoietic SCT (AHSCT) is increasingly used to control severe and refractory autoimmune diseases (AD). Many patients are women of reproductive age with a potential desire for children. We present a multicentre retrospective analysis of pregnancy and childbirth in patients who underwent AHSCT for AD. The databases of the European Blood and Marrow Transplantation and University of Sao Paulo, Ribeirão Preto, Brazil were searched for female patients aged 18–50 years who had received AHSCT for AD between 1994–2011. In 324 adult female patients, 22 pregnancies were reported in 15 patients between 1997–2011. Indications for AHSCT included multiple sclerosis (n=7), systemic sclerosis (n=5), rheumatoid arthritis (n=1), juvenile idiopathic arthritis (n=1) and Takayasu disease (n=1). Of the 22 reported pregnancies, 20 followed natural conception. 15 pregnancies (68%) resulted in healthy life births, whereas 7 (32%) failed. Exacerbations of AD occurred in two patients during second pregnancies. No maternal mortality was associated with pregnancy or postpartum. There were no reports of congenital, developmental or any other disease in the children. This retrospective analysis confirms the possibility of pregnancy and childbirth following AHSCT for severe AD. The outcome of pregnancy is generally good and most led to the birth of a healthy child.

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Author notes

  1. E Snarski and J A Snowden: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland

    E Snarski

  2. Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust & University of Sheffield, Sheffield, UK

    J A Snowden

  3. Division of Clinical Immunology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil

    M C Oliveira

  4. Division of Hematology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil

    B Simoes

  5. EBMT Paris Study Office, ADWP-EBMT, Hopital Saint-Antoine, Assistance Publique des Hôpitaux de Paris, UPMC Univ Paris 06, UMR-S 938, Paris, France

    M Badoglio

  6. Department of Haematology, University Hospital, Uppsala, Sweden

    K Carlson

  7. Department of Neurosciences, Uppsala University, Uppsala, Sweden

    J Burman

  8. Department of Neurology, Uppsala University Hospital, Uppsala, Sweden

    J Burman

  9. The Haematology and Bone Marrow Transplant Department, St Vincent’s Hospital, Sydney, NSW, Australia

    J Moore & J Tan

  10. Hematology Department, BMT Unit, Hospital Clinic and Institut d'Investigació Biomèdiques August PI i Sunyer (IDIBAPS), Barcelona, Spain

    M Rovira

  11. Department of Hematology, Royal Liverpool University Hospital, Liverpool, UK

    R E Clark

  12. Neurology Service, Hospital Clinic and Institut d'Investigació Biomèdiques August PI i Sunyer (IDIBAPS), Barcelona, Spain

    A Saiz

  13. Department of Internal Medicine, CHU Purpan, Toulouse, France

    S Hadj-Khelifa

  14. Unità Operativa di Oncoematologia e Trapianto di Midollo, Ospedale La Maddalena, Palermo, Italy

    A Crescimanno & M Musso

  15. Strasbourg University Hospital CNRS UPR 3572, Strasbourg, France

    T Martin

  16. Internal Medicine and Vascular Disease Unit UH 04, Assistance Publique Hôpitaux de Paris, INSERM UMRS 1160, France

    D Farge

Authors
  1. E Snarski
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  2. J A Snowden
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  3. M C Oliveira
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  4. B Simoes
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  5. M Badoglio
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  6. K Carlson
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  7. J Burman
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  8. J Moore
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  9. M Rovira
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  10. R E Clark
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  11. A Saiz
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  12. S Hadj-Khelifa
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  13. J Tan
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  14. A Crescimanno
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  15. M Musso
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  16. T Martin
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  17. D Farge
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Corresponding authors

Correspondence to E Snarski or D Farge.

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The authors declare no conflict of interest.

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Author Contributions

ES, JAS and DF were the principal investigators and take primary responsibility for the paper; they had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: ES, JAS and DF. Acquisition of data: MB, DF, SHK, JAS, JM, MM, AC, JT, TM, MR, AS, MCO, BPS, RC, CC and JB recruited the patients. Drafting of the manuscript: ES, JS and DF. Statistical analysis: MB and ML. Administrative, technical or material support: EBMT.

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Snarski, E., Snowden, J., Oliveira, M. et al. Onset and outcome of pregnancy after autologous haematopoietic SCT (AHSCT) for autoimmune diseases: a retrospective study of the EBMT autoimmune diseases working party (ADWP). Bone Marrow Transplant 50, 216–220 (2015). https://doi.org/10.1038/bmt.2014.248

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