Effect of autologous stem cell transplantation on women’s fertility

This article looks at the effect that autologous stem cell transplantation has on the fertility of women with Hodgkin or non-Hodgkin lymphoma. The study concluded that women had a surprisingly high rate of good fertility outcomes after autologous stem cell transplantation.

Autologous stem cell transplantation (auto-SCT; using the patient’s own stem cells) is a common treatment for patients with relapsed Hodgkin and non-Hodgkin lymphoma. Before receiving auto-SCT, patients must receive what is called a conditioning regimen. This chemotherapy regimen prepares their body for the stem cell transplantation. BEAM (carmustine, etoposide, cytarabine, and melphalan) is the most common conditioning regimen. 

One of the side effects of auto-SCT plus a conditioning regimen in women is infertility or early menopause (menopause before 40 years old). More information is needed about the fertility side effects of auto-SCT + BEAM. 

The medical records of 25 female patients were reviewed. 18 patients had Hodgkin lymphoma and 7 patients had non-Hodgkin lymphoma. All women were pre-menopausal (18-40 years old). The average follow-up time was 8 years.

Overall 68% of women continued menstruation after auto-SCT. The average age of women who continued menstruating was significantly younger (25 years old) than those who did not continue menstruating after auto-SCT (34 years old).

Of the 17 women who continued menstruating, 10 women became pregnant at least once (59%). This group had a total of 15 naturally conceived pregnancies. 12 healthy babies were born and there was 1 miscarriage. Two women are still pregnant. It is unclear how many women tried to get pregnant.

The type of cancer (Hodgkin or non-Hodgkin lymphoma) did not impact fertility. 

The authors concluded that the women in this study had a high rate of menstruation continuation after auto-SCT, particularly younger women.

Only women who were menstruating/were most probably fertile before auto-SCT were included in this study. Women who underwent any previous treatments such as intense chemotherapy or radiation therapy that may have made them infertile were excluded. This study only looks at the effect of auto-SCT + BEAM on women’s fertility.