Беременности после терапии CAR-T у женщин с аутоиммунными заболеваниями прошли без осложнений

(HealthDay News) — For women with autoimmune disease who had received autologous CD19-chimeric antigen receptor (CAR) T-cell therapy, pregnancies seem to be uncomplicated without disease reactivation, according to a study published in the Aug. 20/27 issue of the New England Journal of Medicine. Georg Schett, M.D., from Friedrich-Alexander-Universität Erlangen-Nürnberg in Germany, and colleagues reported data on 14 pregnancies in 13 patients with autoimmune disease who underwent CAR T-cell treatment. All conceptions occurred spontaneously; eight healthy neonates were born in 2025 and 2026, and five women are currently pregnant with anticipated deliveries. Patients received conditioning therapy with cyclophosphamide (median dose, 1,470 mg) and fludarabine (median dose, 133 mg). The researchers found no relapses of autoimmune diseases during any of the pregnancies, including in eight patients with systemic lupus erythematosus. All but one patient remained drug-free or only received prophylactic hydroxychloroquine; one patient had an increase in proteinuria and renal-retention variables in the context of preeclampsia and received tacrolimus after delivery. No CAR T-cells were found in the eight neonates. All births occurred at full-term gestation, with normal birth weights and head circumferences and good Apgar scores (median, 10). “Pregnancies resulted in healthy neonates with a B-cell composition and immunoglobulin levels resembling the typical physiological state of a newborn, with no evidence of neonatal infections,” the authors write. Several authors disclosed ties to the biopharmaceutical industry. Abstract/Full Text (subscription or payment may be required)