Twelve pregnancies follow CAR-T therapy for autoimmune disease

Seven women had healthy newborns and five more had normal pregnancies after CAR-T treatment for autoimmune diseases, a small study reports.

A study published July 29 in the New England Journal of Medicine describes seven women who gave birth to healthy newborns after receiving CAR T cell therapy for autoimmune diseases, mostly lupus. As of late May, five additional women were experiencing normal pregnancies. The women came from Germany, Belgium, China, Switzerland, France, and the United States, and all were in remission. The work, led by immunologist Georg Schett in Germany, is described as the largest snapshot to date of pregnancy after CAR-T for autoimmune disease.

CAR-T therapy engineers a patient's T cells to destroy the B cells attacking their body. The women became pregnant naturally, between one month and three and a half years after treatment, and none had reactivations of their disease during pregnancy. The seven newborns had normal weights, no infections at birth, normal immune protein levels, and, in five tested, the expected immune cell allotments.

For abundance in care, the finding chips away at a real barrier: fear that a powerful cell therapy forecloses future childbearing. If the therapy proves compatible with healthy pregnancy, more young patients could accept a treatment that has already put lupus patients into remission, expanding who benefits.

The caveats are substantial. The study is small. CAR-T carries risks of infection and other serious side effects, and there are very few pregnancy reports following its use in cancer. Untreated autoimmune disease also poses its own pregnancy risks. Larger follow-up will be needed.

Source: Science News