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Supportive Care in Cancer
Published in: Supportive Care in Cancer 12/2019

01-12-2019 | Fertility | Review Article

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

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

Published in: Supportive Care in Cancer | Issue 12/2019

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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.
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Metadata
Title
Reproductive outcomes following a stem cell transplant for a haematological malignancy in female cancer survivors: a systematic review and meta-analysis
Authors
Brigitte Gerstl
Elizabeth Sullivan
Jana Koch
Handan Wand
Angela Ives
Richard Mitchell
Nada Hamad
Antoinette Anazodo
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 12/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-019-05020-8

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