First reported case of a spontaneous and healthy pregnancy in a woman with persistent CAR T-cells 5 years after treatment for diffuse large B-cell lymphoma.

in Journal for immunotherapy of cancer by Ethan Abraham Canty, Lori Broderick, Daniel Flaherty, Marin Xavier, Sunita D Nasta, Lina Dajani, Andrew A White

TLDR

  • A woman who had CAR T-cell therapy for cancer later became pregnant and delivered a healthy baby; the study suggests that CAR T-cell therapy may not significantly impact fertility or newborn health.

Abstract

Chimeric antigen receptor T-cell (CAR T-cell) therapy has significantly advanced cancer treatments and remission rates; however, questions exist regarding the impacts on both fertility and immune effects on infants born to mothers who have undergone CAR T-cell therapy. There are no known reported cases of persistence of CAR T-cells after cancer therapy in pregnancy. Here, we present a case of a woman with relapsed refractory diffuse large B-cell lymphoma who undertook an experimental CAR T-cell therapy, had persistence of CAR T-cells 5 years after achieving remission, spontaneously became pregnant and delivered a healthy male infant. Our case provides an example of a healthy pregnancy despite the persistence of CAR T-cells and the resultant healthy newborn without evidence of immunologic or other health effects from the CAR T-cells.

Overview

  • The study presents a case of a woman with relapsed refractory diffuse large B-cell lymphoma who underwent experimental CAR T-cell therapy and became pregnant 5 years after achieving remission.
  • The study aims to explore the potential impacts of CAR T-cell therapy on fertility and immune effects on infants born to mothers who have undergone the therapy.
  • The primary objective of the study is to investigate the persistence of CAR T-cells after cancer therapy in pregnancy and its potential effects on newborn health.

Comparative Analysis & Findings

  • The study presents a single case report of a healthy pregnancy following CAR T-cell therapy and delivery of a healthy male infant.
  • The persistence of CAR T-cells 5 years after therapy was detected, but there was no evidence of immunologic or other health effects on the newborn.
  • The study suggests that CAR T-cell therapy may not significantly impact fertility or immunity in infants born to mothers who have undergone the therapy.

Implications and Future Directions

  • The study's findings could have significant implications for the use of CAR T-cell therapy in women of childbearing age and the potential effects on newborn health.
  • Future research should aim to establish the safety and efficacy of CAR T-cell therapy in pregnant women and its effects on newborns.
  • The study raises important questions regarding the long-term persistence of CAR T-cells and their potential effects on infant health, warranting further investigation.
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