Identifying risks and improving pregnancy care in childhood cancer survivors

Thanks to improved survival and assisted fertility technologies like IVF, more women who had cancer treatment as a child or young adult are now able to have children. Unfortunately, evidence suggests that they are more likely to experience problems during pregnancy, including an increased risk of their babies being born prematurely. Dr Melanie Griffin of University Hospitals Bristol NHS Foundation Trust is looking at the long-term impact of cancer treatment involving bone marrow transplantation on women’s reproductive health. She hopes to identify new ways to improve care for these childhood cancer survivors before and during their pregnancy, reducing the chances of their babies being born too soon.

Action Medical Research and Borne are jointly funding this research. Action Medical Research are grateful for the generous support of The James Tudor Foundation towards this project.

How are children’s lives affected now?

Thanks to advances in treatment, more childhood cancer survivors than ever before are reaching adulthood and starting families of their own.

“While many women will successfully conceive, we believe that they are more likely to experience problems during pregnancy – especially if they had radiotherapy to their womb area,”  says Dr Griffin.

Figures suggest around 400 boys and girls every year in the UK undergo a bone marrow transplant as part of their cancer treatment.¹ This involves chemotherapy and/or radiotherapy (sometimes to the child’s entire body) to kill all of their cancer cells – and then replacing their bone marrow with healthy cells.

“We suspect that women who have had a bone marrow transplant have a particularly high risk of pregnancy complications – including having their babies very early,” says Dr Griffin.

Being born too soon is the major cause of death and illness in the first month of life. Knowing how best to care for this group of women during their pregnancy could help to reduce their risk of preterm birth.

How could this research help?

“We are aiming to improve our understanding of the impact of bone marrow transplantation on a woman’s risk of problems during pregnancy,” says Dr Griffin.

Using data from large population studies, the team will study pregnancy complications experienced by women who have had a bone marrow transplant when they were younger.

“We will also investigate if a bone marrow transplant still increases a woman’s risk of preterm birth if they have not had radiotherapy to their entire body,” says Dr Griffin.

The researchers will also establish what care is currently given to women in the UK who conceive after bone marrow transplantation and develop recommendations on how best to look after these women and their babies in the future.

“If we can prove that these women have an increased risk of pregnancy problems, they could be offered specialist care before and during pregnancy to reduce the risk of their babies being born too soon,” says Dr Griffin.

References:

1. British Society of Blood and Bone Marrow Transplantation: http://bsbmt.org/activity/2017/ [website accessed 13^th August 2019]

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