Reproductive outcomes following a stem cell transplant for a haematological malignancy in female cancer survivors: a systematic review and meta-analysis

Brigitte Gerstl, Elizabeth Sullivan, Jana Koch, Handan Wand, Angela Ives, Richard Mitchell, Nada Hamad, Antoinette Anazodo

Research output: Contribution to journalReview article

Abstract

Purpose: The use of high-dose chemotherapy and radiotherapy combined with haematopoietic stem cell transplantation (HSCT) may negatively affect a woman’s reproductive potential. Reproductive outcomes such as infertility are a major concern for women who undergo treatment for a haematological cancer diagnosis. Objective: This systematic review and meta-analysis explores reproductive outcomes following a haematological cancer requiring HSCT. Methods: Electronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a haematological cancer diagnosis. Studies were included that reported on pregnancy and reproductive outcomes following HSCT for a haematological malignancy. Results: The meta-analysis included 14 studies, collectively involving 744 female patients. The subgroup analysis showed an overall pooled estimated pregnancy rate, for autologous or allogeneic HSCT recipients, of 22.7% (n = 438). There were 25% (n = 240) of women who became pregnant after autologous HSCT compared with 22% (n = 198) who subsequently became pregnant following allogeneic HSCT. Conclusions: This meta-analysis reflects low pregnancy rates for cancer survivors desiring a family. However, live births are improving over time with new technology and novel therapies. Hence, female cancer patients should be offered timely discussions, counselling and education around fertility preservation options prior to starting treatment with gonadotoxic therapy.

Original languageEnglish
JournalSupportive Care in Cancer
DOIs
Publication statusE-pub ahead of print - 21 Sep 2019

Fingerprint

Hematopoietic Stem Cell Transplantation
Hematologic Neoplasms
Survivors
Meta-Analysis
Stem Cells
Transplants
Neoplasms
Pregnancy Rate
Fertility Preservation
Live Birth
Therapeutics
Pregnancy Outcome
Infertility
Counseling
Radiotherapy
Databases
Technology
Education
Drug Therapy

Cite this

Gerstl, Brigitte ; Sullivan, Elizabeth ; Koch, Jana ; Wand, Handan ; Ives, Angela ; Mitchell, Richard ; Hamad, Nada ; Anazodo, Antoinette. / Reproductive outcomes following a stem cell transplant for a haematological malignancy in female cancer survivors : a systematic review and meta-analysis. In: Supportive Care in Cancer. 2019.
@article{1310c96bedff424e88cc4a8227baff97,
title = "Reproductive outcomes following a stem cell transplant for a haematological malignancy in female cancer survivors: a systematic review and meta-analysis",
abstract = "Purpose: The use of high-dose chemotherapy and radiotherapy combined with haematopoietic stem cell transplantation (HSCT) may negatively affect a woman’s reproductive potential. Reproductive outcomes such as infertility are a major concern for women who undergo treatment for a haematological cancer diagnosis. Objective: This systematic review and meta-analysis explores reproductive outcomes following a haematological cancer requiring HSCT. Methods: Electronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a haematological cancer diagnosis. Studies were included that reported on pregnancy and reproductive outcomes following HSCT for a haematological malignancy. Results: The meta-analysis included 14 studies, collectively involving 744 female patients. The subgroup analysis showed an overall pooled estimated pregnancy rate, for autologous or allogeneic HSCT recipients, of 22.7{\%} (n = 438). There were 25{\%} (n = 240) of women who became pregnant after autologous HSCT compared with 22{\%} (n = 198) who subsequently became pregnant following allogeneic HSCT. Conclusions: This meta-analysis reflects low pregnancy rates for cancer survivors desiring a family. However, live births are improving over time with new technology and novel therapies. Hence, female cancer patients should be offered timely discussions, counselling and education around fertility preservation options prior to starting treatment with gonadotoxic therapy.",
keywords = "Birth, Haematological malignancies, Oncofertility, Pregnancy, Reproductive outcome, Stem cell transplant",
author = "Brigitte Gerstl and Elizabeth Sullivan and Jana Koch and Handan Wand and Angela Ives and Richard Mitchell and Nada Hamad and Antoinette Anazodo",
year = "2019",
month = "9",
day = "21",
doi = "10.1007/s00520-019-05020-8",
language = "English",
journal = "Supportive Care in Cancer",
issn = "0941-4355",
publisher = "Springer-Verlag London Ltd.",

}

Reproductive outcomes following a stem cell transplant for a haematological malignancy in female cancer survivors : a systematic review and meta-analysis. / Gerstl, Brigitte; Sullivan, Elizabeth; Koch, Jana; Wand, Handan; Ives, Angela; Mitchell, Richard; Hamad, Nada; Anazodo, Antoinette.

In: Supportive Care in Cancer, 21.09.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Reproductive outcomes following a stem cell transplant for a haematological malignancy in female cancer survivors

T2 - a systematic review and meta-analysis

AU - Gerstl, Brigitte

AU - Sullivan, Elizabeth

AU - Koch, Jana

AU - Wand, Handan

AU - Ives, Angela

AU - Mitchell, Richard

AU - Hamad, Nada

AU - Anazodo, Antoinette

PY - 2019/9/21

Y1 - 2019/9/21

N2 - Purpose: The use of high-dose chemotherapy and radiotherapy combined with haematopoietic stem cell transplantation (HSCT) may negatively affect a woman’s reproductive potential. Reproductive outcomes such as infertility are a major concern for women who undergo treatment for a haematological cancer diagnosis. Objective: This systematic review and meta-analysis explores reproductive outcomes following a haematological cancer requiring HSCT. Methods: Electronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a haematological cancer diagnosis. Studies were included that reported on pregnancy and reproductive outcomes following HSCT for a haematological malignancy. Results: The meta-analysis included 14 studies, collectively involving 744 female patients. The subgroup analysis showed an overall pooled estimated pregnancy rate, for autologous or allogeneic HSCT recipients, of 22.7% (n = 438). There were 25% (n = 240) of women who became pregnant after autologous HSCT compared with 22% (n = 198) who subsequently became pregnant following allogeneic HSCT. Conclusions: This meta-analysis reflects low pregnancy rates for cancer survivors desiring a family. However, live births are improving over time with new technology and novel therapies. Hence, female cancer patients should be offered timely discussions, counselling and education around fertility preservation options prior to starting treatment with gonadotoxic therapy.

AB - Purpose: The use of high-dose chemotherapy and radiotherapy combined with haematopoietic stem cell transplantation (HSCT) may negatively affect a woman’s reproductive potential. Reproductive outcomes such as infertility are a major concern for women who undergo treatment for a haematological cancer diagnosis. Objective: This systematic review and meta-analysis explores reproductive outcomes following a haematological cancer requiring HSCT. Methods: Electronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a haematological cancer diagnosis. Studies were included that reported on pregnancy and reproductive outcomes following HSCT for a haematological malignancy. Results: The meta-analysis included 14 studies, collectively involving 744 female patients. The subgroup analysis showed an overall pooled estimated pregnancy rate, for autologous or allogeneic HSCT recipients, of 22.7% (n = 438). There were 25% (n = 240) of women who became pregnant after autologous HSCT compared with 22% (n = 198) who subsequently became pregnant following allogeneic HSCT. Conclusions: This meta-analysis reflects low pregnancy rates for cancer survivors desiring a family. However, live births are improving over time with new technology and novel therapies. Hence, female cancer patients should be offered timely discussions, counselling and education around fertility preservation options prior to starting treatment with gonadotoxic therapy.

KW - Birth

KW - Haematological malignancies

KW - Oncofertility

KW - Pregnancy

KW - Reproductive outcome

KW - Stem cell transplant

UR - http://www.scopus.com/inward/record.url?scp=85074029920&partnerID=8YFLogxK

U2 - 10.1007/s00520-019-05020-8

DO - 10.1007/s00520-019-05020-8

M3 - Review article

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

ER -