Department of Neurology, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia/St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW, Australia.
St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW, Australia/Department of Haematology and Bone Marrow Transplantation, St Vincent's Health Network, Darlinghurst, NSW, Australia/Kinghorn Cancer Centre and St Vincent's Centre for Applied Medical Research, Darlinghurst, NSW, Australia.
Mult Scler. 2021 Nov;27(13):2112-2115. doi: 10.1177/13524585211005660. Epub 2021 Apr 19.
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.
To evaluate the rate of pregnancy and complications post-AHSCT for MS.
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.
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.
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.
鉴于全球多发性硬化症（MS）患者接受自体造血干细胞移植（AHSCT）的人数不断增加，且生育年龄的女性在目标人群中占比过高，因此越来越有必要回顾 AHSCT 后的生育和妊娠结局。
评估 MS 患者 AHSCT 后的妊娠率和并发症。
回顾性评估自 2010 年以来，在一家三级转诊中心接受 BEAM 预处理的 MS 患者 AHSCT 后的妊娠率及相关并发症。
在我们正在进行的 MS AHSCT 二期试验中，55 例患者接受了 AHSCT，其中 30 例女性在移植时处于生育年龄。AHSCT 后发生了 4 例妊娠。2 例妊娠足月分娩。在这两种情况下，均未报告母婴并发症。由于选择性终止妊娠，另外 2 例妊娠未足月分娩。在 21 例男性患者中，1 例患者自 AHSCT 后已生育 3 个孩子。无新生儿并发症。
这是我们首次报道 MS 患者 AHSCT 后两性的生育结局。在治疗前，应向患者进行关于不孕和避孕措施的咨询。
