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 - 2019/12/1
Y1 - 2019/12/1
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
C2 - 31541306
AN - SCOPUS:85074029920
SN - 0941-4355
VL - 27
SP - 4451
EP - 4460
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 12
ER -