Objective:

To describe pregnancy and early maternal and infant outcomes after CAR T-cell therapy for autoimmune disease.

Approach:

• Study population: Georg Schett and colleagues reported 14 pregnancies in 13 patients previously treated with CAR T-cell therapy for autoimmune disease.
• Pregnancy and infant follow-up: Pregnancies occurred spontaneously. The report included pregnancy course, birth outcomes, newborn immune findings, and infant follow-up.

Key Findings:

• Eight healthy babies had been born, five pregnancies were ongoing, and one pregnancy was electively terminated for reasons unrelated to autoimmune disease.
• No autoimmune disease flares were reported during pregnancy, including in the eight patients with systemic lupus erythematosus.
• Eight births occurred at a median gestational age of 37 weeks; median birth weight was 2,995 g, and Apgar scores were reassuring.
• No CAR T cells were detected in newborns. CD19-positive B-cell counts and IgG levels were within normal ranges.
• During follow-up of one to 18 months, normal development was reported in all eight infants; one had influenza at eight months.

Interpretation:

The researchers described the reported pregnancies as uncomplicated and without disease reactivation, with overall maternal and neonatal outcomes appearing favorable.

Limitations:

• The report included only 14 pregnancies in 13 patients.
• Infant follow-up was limited to one to 18 months.
• The researchers called for pregnancy registries and further studies of fertility effects from lymphodepletion and CAR T-cell treatment.

Conclusion:

These early observations add to limited evidence on pregnancy after CAR T-cell therapy for autoimmune disease.

Sources:

• Article context provided