{"product_id":"pregnancy-after-car-t-cell-therapy-for-autoimmune-disease-what-14-pregnancies-tell-us","title":"Pregnancy After CAR T-Cell Therapy for Autoimmune Disease: What 14 Pregnancies Tell Us","description":"\u003cp\u003e\u003cstrong\u003eSummary:\u003c\/strong\u003e In a new correspondence letter in the New England Journal of Medicine, researchers report 14 pregnancies in 13 women with autoimmune diseases who had previously received CD19 CAR T-cell therapy. Eight healthy newborns were delivered in 2025 and 2026, five women were still pregnant when the letter was written, and one pregnancy was ended for personal reasons unrelated to autoimmune disease. No woman's autoimmune disease flared during pregnancy. No CAR T cells were found in any newborn. All eight births were full-term, with normal growth measurements and Apgar scores of about 10. The authors conclude that these pregnancies were uncomplicated and the outcomes favorable, but they call for registry data and more fertility research.\u003c\/p\u003e\n\n\u003ch1\u003ePregnancies in Patients with Autoimmune Disease Receiving CAR T-Cell Therapy\u003c\/h1\u003e\n\n\u003ch2\u003eTable of Contents\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003e\u003ca href=\"#ddn-key-points\"\u003eKey Points\u003c\/a\u003e\u003c\/li\u003e\n\n  \u003cli\u003e\u003ca href=\"#background\"\u003eWhy This Research Matters\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#cart\"\u003eWhat Is CD19 CAR T-Cell Therapy?\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#methods\"\u003eHow the Researchers Collected the Data\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#cohort\"\u003eWho Was Studied\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#mothers\"\u003eKey Findings: The Mothers\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#newborns\"\u003eKey Findings: The Newborns\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#fertility\"\u003eConditioning Doses and Fertility\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#implications\"\u003eWhat These Results Mean for Patients\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#limitations\"\u003eLimitations: What the Study Could Not Prove\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#recommendations\"\u003ePractical Recommendations for Patients\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#ddn-faq\"\u003eFrequently Asked Questions\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#source\"\u003eSource Information\u003c\/a\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003c!-- ddn:keypoints:start --\u003e\n\u003ch2 id=\"ddn-key-points\"\u003eKey Points\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003eIn 14 pregnancies among 13 women with autoimmune disease previously treated with CD19 CAR T-cell therapy, no autoimmune flares occurred, including in eight women with lupus.\u003c\/li\u003e\n\u003cli\u003eEight healthy newborns were delivered full-term in 2025 and 2026, with normal growth measurements, Apgar scores around 10, and no infections reported.\u003c\/li\u003e\n\u003cli\u003eNo CAR T cells were detected in any of the eight newborns, and their B-cell and immunoglobulin levels resembled those of typical healthy newborns.\u003c\/li\u003e\n\u003cli\u003eAll conceptions were spontaneous; the authors note that conditioning chemotherapy doses were below a level shown not to reduce fertility, but call for more hormone studies.\u003c\/li\u003e\n\u003cli\u003eThe authors conclude outcomes were favorable but stress the small numbers, ongoing pregnancies, and need for registry data before drawing firm conclusions.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c!-- ddn:keypoints:end --\u003e\n\n\n\u003ch2 id=\"background\"\u003eWhy This Research Matters\u003c\/h2\u003e\n\u003cp\u003eAutoimmune diseases (conditions in which the immune system mistakenly attacks the body's own tissues) most often begin in women during their childbearing years. That timing matters a great deal, because these diseases can interfere with a woman's ability to conceive and to carry a pregnancy safely. Earlier research shows that pregnancies in women with autoimmune disease carry higher risks for both the mother and the baby (this finding comes from an umbrella review of many studies, published in \u003cem\u003eBMC Medicine\u003c\/em\u003e in 2024).\u003c\/p\u003e\n\n\u003cp\u003eA newer treatment is changing that picture. Autologous CD19 chimeric antigen receptor (CAR) T-cell therapy (a \"living drug\" made from a patient's own immune cells) has produced sustained, drug-free remission in autoimmune disease. Because women usually take powerful immunosuppressive medicines before this treatment, reaching drug-free remission should improve the chances of a healthy pregnancy.\u003c\/p\u003e\n\n\u003cp\u003eUntil now, however, nobody knew whether pregnancy after CAR T-cell therapy is safe. Two concerns stood out for the researchers. First, without immunosuppressive medication during pregnancy, the autoimmune disease might flare up again. Second, the mother's B cells stay depleted for a long time after treatment. B cells are the immune cells that make protective antibodies. That deep B-cell depletion could harm the fetus or the newborn.\u003c\/p\u003e\n\n\u003cp\u003eData from cancer patients offer little guidance. People who receive CAR T cells for cancer are often at risk of infertility from earlier chemotherapy, or they are of an age at which pregnancy is not an option. Only isolated pregnancies have been described in patients with blood cancers who received CAR T cells (a 2025 report described two such cases). Given that tens of thousands of patients have received CAR T cells for cancer, that number is remarkably low — even allowing for the fact that not every pregnancy is documented.\u003c\/p\u003e\n\n\u003ch2 id=\"cart\"\u003eWhat Is CD19 CAR T-Cell Therapy?\u003c\/h2\u003e\n\u003cp\u003e\u003cstrong\u003eCAR T-cell therapy\u003c\/strong\u003e begins with collecting a patient's own T cells (a type of white blood cell that normally coordinates immune attacks). Scientists then genetically reprogram those cells to carry a chimeric antigen receptor, or CAR, which recognizes \u003cstrong\u003eCD19\u003c\/strong\u003e — a protein found on the surface of B cells. The reprogrammed cells are grown in large numbers and given back to the patient.\u003c\/p\u003e\n\n\u003cp\u003eBefore the infusion, patients receive \u003cstrong\u003elymphodepletion conditioning\u003c\/strong\u003e (a short course of chemotherapy given to make room for the new cells). In this group of patients, conditioning used two drugs: \u003cstrong\u003ecyclophosphamide\u003c\/strong\u003e and \u003cstrong\u003efludarabine\u003c\/strong\u003e. Once infused, the CAR T cells seek out and destroy B cells throughout the body. In autoimmune disease, this removes the B cells that help drive the attack on the body's own tissues, which in many patients leads to a lasting remission without ongoing medication.\u003c\/p\u003e\n\n\u003ch2 id=\"methods\"\u003eHow the Researchers Collected the Data\u003c\/h2\u003e\n\u003cp\u003eThis report is a case series published as a letter to the editor, not a randomized trial. The authors gathered information on 14 pregnancies that occurred in 13 patients with autoimmune disease who had previously been treated with CAR T-cell therapy. Three of the cases (pregnancies 4, 7, and 8) had already been described in earlier publications.\u003c\/p\u003e\n\n\u003cp\u003eFor each pregnancy, the researchers collected:\u003c\/p\u003e\n\u003cul\u003e\n  \u003cli\u003eDemographic characteristics (such as age and country of treatment)\u003c\/li\u003e\n  \u003cli\u003eMedication records both at the onset of the autoimmune disease and during pregnancy\u003c\/li\u003e\n  \u003cli\u003eDisease-related and treatment-related details, including which CAR T-cell product was used and the conditioning doses\u003c\/li\u003e\n  \u003cli\u003eMaternal outcomes, including whether the autoimmune disease relapsed\u003c\/li\u003e\n  \u003cli\u003eNeonatal outcomes included gestational age at delivery, mode of delivery, birth weight, length, head circumference, and Apgar scores. Apgar scores are a standard 0-to-10 rating of a newborn's health right after birth, where 10 is best.\u003c\/li\u003e\n  \u003cli\u003eLaboratory studies of the newborns, including counts of CD19-positive B cells and levels of immunoglobulins (antibodies such as IgG, IgA, and IgM)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003ePatient characteristics are detailed in Table S1 of the Supplementary Appendix, and medication records from disease onset and during pregnancy are presented in Table S2. Growth percentiles for weight, length, and head circumference over time appear in Table S3.\u003c\/p\u003e\n\n\u003ch2 id=\"cohort\"\u003eWho Was Studied\u003c\/h2\u003e\n\u003cp\u003eThe series included 13 women with 14 pregnancies. Their ages ranged from 17 to 35 years, and they were treated at centers in six countries: Germany, France, Switzerland, the United States, China, and Belgium. The underlying diagnoses were:\u003c\/p\u003e\n\u003cul\u003e\n  \u003cli\u003eSystemic lupus erythematosus (SLE) — 8 patients\u003c\/li\u003e\n  \u003cli\u003eSystemic sclerosis (SSc) — 2 patients\u003c\/li\u003e\n  \u003cli\u003eIdiopathic inflammatory myositis (IIM, a muscle-inflaming autoimmune disease) — 1 patient\u003c\/li\u003e\n  \u003cli\u003eOverlap syndrome (systemic sclerosis plus rheumatoid arthritis) — 1 patient\u003c\/li\u003e\n  \u003cli\u003eAntiphospholipid syndrome (APS, a clotting disorder driven by autoantibodies) — 1 patient\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eImportantly, every conception happened spontaneously. None of the 14 pregnancies resulted from assisted reproductive technology such as in vitro fertilization.\u003c\/p\u003e\n\n\u003ch2 id=\"mothers\"\u003eKey Findings: The Mothers\u003c\/h2\u003e\n\u003cp\u003eThe most striking maternal finding is simple: \u003cstrong\u003eno relapses of autoimmune disease occurred during any of the pregnancies\u003c\/strong\u003e, including in the eight patients with SLE — a disease that is well known for flaring during pregnancy.\u003c\/p\u003e\n\n\u003cp\u003eAll but one patient remained completely drug-free or received only prophylactic hydroxychloroquine (an antimalarial drug commonly used to prevent lupus flares). The single exception was Patient 4, who developed proteinuria (protein in the urine) along with changes in renal-retention variables in the context of preeclampsia (a pregnancy complication marked by high blood pressure and organ stress). She received tacrolimus after delivery, even though a renal biopsy showed no signs of active lupus nephritis (kidney inflammation from lupus).\u003c\/p\u003e\n\n\u003cp\u003eAll eight births occurred at full-term gestation. The median gestational age at delivery was 37 weeks (interquartile range, 36.25 to 39.75 weeks), meaning the middle half of the births took place between about 36 and 40 weeks. One of the eight deliveries was by cesarean section. Every woman in the series chose to breast-feed her newborn.\u003c\/p\u003e\n\n\u003cp\u003eAt the time the letter was written, five additional women were pregnant with anticipated deliveries. One woman had chosen to end her pregnancy for personal reasons unrelated to her autoimmune disease. Looking at the whole group, then, 8 babies had been born, 5 pregnancies were ongoing, and 1 pregnancy ended electively.\u003c\/p\u003e\n\n\u003ch2 id=\"newborns\"\u003eKey Findings: The Newborns\u003c\/h2\u003e\n\u003cp\u003eEight healthy neonates were born in 2025 and 2026, and no neonatal infections were reported. The growth and health measurements were all in the normal range:\u003c\/p\u003e\n\u003cul\u003e\n  \u003cli\u003e\n\u003cstrong\u003eBirth weight:\u003c\/strong\u003e median 2995 grams (interquartile range, 2778 to 3268 g)\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eLength:\u003c\/strong\u003e median 49.75 cm (interquartile range, 46.25 to 51.63 cm)\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eHead circumference:\u003c\/strong\u003e median 33.25 cm (interquartile range, 32.00 to 35.00 cm)\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eApgar scores:\u003c\/strong\u003e median 10 (interquartile range, 9.2 to 10) — essentially the highest possible score\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eThe laboratory results were equally reassuring. \u003cstrong\u003eNo CAR T cells were detected in any of the eight newborns\u003c\/strong\u003e (median, 0 cells per milliliter; interquartile range, 0 to 0). In other words, the engineered immune cells given to the mothers did not cross into the babies.\u003c\/p\u003e\n\n\u003cp\u003eThe newborns also had normal immune measurements. Their CD19-positive B cells were present at a median of 252 per milliliter (interquartile range, 173 to 449). Their IgG levels were a median of 692 mg per deciliter (interquartile range, 424 to 903). IgG is immunoglobulin G, the main antibody that protects against infection. Detailed analysis of B cells and immunoglobulins showed a physiologically naïve B-cell compartment. This pattern matches the normal, expected immune state of a healthy newborn rather than a depleted one.\u003c\/p\u003e\n\n\u003cp\u003ePercentiles for weight, length, and head circumference, and how those measurements developed over time, are shown in Table S3 of the Supplementary Appendix.\u003c\/p\u003e\n\n\u003ch2 id=\"fertility\"\u003eConditioning Doses and Fertility\u003c\/h2\u003e\n\u003cp\u003eFertility was a central worry, so the researchers examined the chemotherapy doses used before the CAR T-cell infusion. Patients received conditioning therapy with cyclophosphamide at a median dose of 1470 mg (interquartile range, 1090 to 1658 mg) and with fludarabine at a median dose of 133 mg (interquartile range, 100 to 171 mg).\u003c\/p\u003e\n\n\u003cp\u003eThose cumulative cyclophosphamide doses were well below the cumulative dose used in the Euro-Lupus treatment protocol (3000 mg), a regimen that has been shown not to reduce fertility. That comparison offers a plausible explanation for why these women were able to conceive naturally.\u003c\/p\u003e\n\n\u003cp\u003eEven so, the authors caution that more work is needed. In their words, additional endocrinologic studies (hormone and reproductive-hormone testing) are needed to assess the effect of lymphodepletion and CAR T cells on fertility.\u003c\/p\u003e\n\n\u003ch2 id=\"implications\"\u003eWhat These Results Mean for Patients\u003c\/h2\u003e\n\u003cp\u003eThe authors conclude that pregnancies in patients with autoimmune disease who had received CAR T-cell therapy were uncomplicated and occurred without disease reactivation. Overall maternal and neonatal outcomes appeared favorable.\u003c\/p\u003e\n\n\u003cp\u003eSeveral points stand out for patients and the clinicians who counsel them:\u003c\/p\u003e\n\u003cul\u003e\n  \u003cli\u003e\n\u003cstrong\u003eDisease control held up.\u003c\/strong\u003e Not one of the 14 pregnancies was complicated by an autoimmune flare, even among the women with lupus, who are traditionally considered high risk.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eThe babies were born healthy.\u003c\/strong\u003e All eight newborns were full-term, with normal size measurements, near-perfect Apgar scores, and no infections.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eThe babies' immune systems looked normal.\u003c\/strong\u003e Their B-cell composition and immunoglobulin levels resembled the typical physiological state of a newborn. This suggests that the mother's deep B-cell depletion did not leave the infant immunocompromised.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eNo CAR T cells reached the babies.\u003c\/strong\u003e The engineered cells were undetectable in every newborn tested.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eBreast-feeding was possible.\u003c\/strong\u003e All the women chose to breast-feed their newborns, and no problems in the infants were reported.\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eFor women who have received CAR T-cell therapy for an autoimmune disease and are considering a family, these results are encouraging. Still, the authors emphasize that the findings come from a small group and that decisions about pregnancy should be made individually with a rheumatologist and the treating CAR T-cell team.\u003c\/p\u003e\n\n\u003ch2 id=\"limitations\"\u003eLimitations: What the Study Could Not Prove\u003c\/h2\u003e\n\u003cp\u003eThis report is a letter describing a case series, and its limits deserve attention:\u003c\/p\u003e\n\n\u003col\u003e\n  \u003cli\u003e\n\u003cstrong\u003eThe numbers are small.\u003c\/strong\u003e Fourteen pregnancies in 13 patients is far too few to draw firm statistical conclusions, and no comparison group was included.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eFive pregnancies were still ongoing.\u003c\/strong\u003e Their outcomes were unknown when the letter was written, so the total picture is incomplete.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eThree cases were already published.\u003c\/strong\u003e Pregnancies 4, 7, and 8 had appeared in earlier reports, so this series partly repeats existing information.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003ePregnancy reporting is incomplete.\u003c\/strong\u003e The authors note that not all pregnancies occurring after CAR T-cell therapy are documented, which can make results look better or worse than reality.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eFertility effects remain unmeasured.\u003c\/strong\u003e The researchers could not determine from these data how lymphodepletion and CAR T cells affect a woman's fertility; dedicated hormone studies are still needed.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eFollow-up is short term.\u003c\/strong\u003e Growth data for the children cover only the early months of life, so long-term development is unknown.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eOne pregnancy was excluded from outcome analysis.\u003c\/strong\u003e The elective termination was performed for personal reasons unrelated to autoimmune disease, so it provides no information about treatment-related risk.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003ePotential conflicts of interest.\u003c\/strong\u003e Several authors are affiliated with pharmaceutical companies that develop CAR T-cell products, including Novartis (Basel, Switzerland), Bristol Myers Squibb (Princeton, NJ), and Cabaletta Bio (Philadelphia).\u003c\/li\u003e\n\u003c\/ol\u003e\n\n\u003cp\u003eThe authors call for registry documentation of pregnancies in patients with autoimmune disease who receive CAR T-cell treatment. A registry — a systematic, ongoing collection of cases — would capture far more pregnancies and give a clearer picture of safety over time.\u003c\/p\u003e\n\n\u003ch2 id=\"recommendations\"\u003ePractical Recommendations for Patients\u003c\/h2\u003e\n\u003cp\u003eBased on this report and the authors' own conclusions, women who have received CAR T-cell therapy for autoimmune disease should consider the following steps if they are thinking about pregnancy:\u003c\/p\u003e\n\n\u003col\u003e\n  \u003cli\u003e\n\u003cstrong\u003ePlan ahead with your care team.\u003c\/strong\u003e Discuss pregnancy plans with your rheumatologist and the team that delivered your CAR T-cell therapy before you try to conceive.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eAsk about registry participation.\u003c\/strong\u003e The authors specifically recommend registry documentation. Joining a registry helps future patients and gives your own pregnancy closer monitoring.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eKeep taking prophylactic medication if it is prescribed.\u003c\/strong\u003e In this series, most women stayed completely drug-free or took only hydroxychloroquine for flare prevention. Do not stop any medication without medical advice.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eWatch for signs of preeclampsia.\u003c\/strong\u003e One patient developed proteinuria and renal changes alongside preeclampsia. Report new swelling, headaches, vision changes, or high blood-pressure readings promptly.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eExpect close monitoring of the baby.\u003c\/strong\u003e Newborn B-cell and immunoglobulin testing can confirm that the infant's immune system is developing normally.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eAsk about fertility assessment.\u003c\/strong\u003e Because the effect of lymphodepletion and CAR T cells on fertility is still unknown, ask your team whether hormone testing is appropriate for you.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eRemember that individual results vary.\u003c\/strong\u003e These 13 women had favorable outcomes, but a case series cannot guarantee the same result for everyone.\u003c\/li\u003e\n\u003c\/ol\u003e\n\n\u003cp\u003eIn short: the news is encouraging, and families should feel able to raise the question of pregnancy with their doctors. The answer, however, still needs to be tailored to each patient.\u003c\/p\u003e\n\n\u003c!-- ddn:faq:start --\u003e\n\u003ch2 id=\"ddn-faq\"\u003eFrequently Asked Questions\u003c\/h2\u003e\n\u003ch3\u003eI had CAR T-cell therapy for lupus. Can I get pregnant?\u003c\/h3\u003e\n\u003cp\u003eIn a report of 14 pregnancies in 13 women with autoimmune diseases who had previously received CD19 CAR T-cell therapy, every conception happened spontaneously, without assisted reproductive technology. The authors note that the chemotherapy doses used before infusion were below a level shown not to reduce fertility, but they call for more hormone studies to assess fertility effects.\u003c\/p\u003e\n\u003ch3\u003eWill my autoimmune disease flare during pregnancy after CAR T-cell therapy?\u003c\/h3\u003e\n\u003cp\u003eIn the reported 14 pregnancies, no woman's autoimmune disease flared, including eight women with systemic lupus erythematosus, a disease known for flaring in pregnancy. All but one remained drug-free or took only prophylactic hydroxychloroquine. One patient developed proteinuria and renal changes with preeclampsia, but a kidney biopsy showed no active lupus nephritis.\u003c\/p\u003e\n\u003ch3\u003eAre the babies born after maternal CAR T-cell therapy healthy?\u003c\/h3\u003e\n\u003cp\u003eEight healthy newborns were delivered in 2025 and 2026. All were full-term with normal growth measurements and Apgar scores around 10. No neonatal infections were reported. Their immune systems appeared normal, with B-cell and immunoglobulin levels matching a typical newborn. No CAR T cells were detected in any of the eight newborns tested.\u003c\/p\u003e\n\u003ch3\u003eCan the CAR T cells pass to my baby or affect its immune system?\u003c\/h3\u003e\n\u003cp\u003eIn the eight newborns tested, no CAR T cells were detected (median 0 cells per milliliter). Their immune measurements were normal: CD19-positive B cells were present at a median of 252 per milliliter, and IgG levels were a median of 692 mg per deciliter. This pattern matched a healthy newborn's expected immune state, suggesting the mother's B-cell depletion did not leave the infant immunocompromised.\u003c\/p\u003e\n\u003ch3\u003eIs breastfeeding safe after CAR T-cell therapy for autoimmune disease?\u003c\/h3\u003e\n\u003cp\u003eIn the reported series, every woman chose to breast-feed her newborn, and no problems in the infants were reported. The authors do not state any restriction on breastfeeding based on these cases. However, because the data come from a small group, decisions about breastfeeding should be made individually with your rheumatologist and the treating CAR T-cell team.\u003c\/p\u003e\n\u003ch3\u003eWhat are the risks of pregnancy after CAR T-cell therapy?\u003c\/h3\u003e\n\u003cp\u003eThe main concerns were autoimmune flare without immunosuppressive medication and possible harm to the fetus from deep B-cell depletion. In the 14 reported pregnancies, no flares occurred and the eight newborns were healthy. One mother developed preeclampsia with proteinuria. The authors stress that the small numbers cannot prove safety for everyone, and outcomes may vary.\u003c\/p\u003e\n\u003ch3\u003eShould I join a registry if I become pregnant after CAR T-cell therapy?\u003c\/h3\u003e\n\u003cp\u003eThe authors specifically recommend registry documentation of pregnancies in patients with autoimmune disease who receive CAR T-cell treatment. A registry systematically collects cases, which would capture far more pregnancies and give a clearer picture of safety over time. Joining helps future patients and may provide closer monitoring for your own pregnancy. Discuss participation with your care team.\u003c\/p\u003e\n\u003ch3\u003eI had CAR T-cell therapy for lupus and I'm thinking about getting pregnant — when should I seek a second opinion?\u003c\/h3\u003e\n\u003cp\u003eBecause these findings come from only 14 pregnancies in 13 women, with five outcomes still unknown and fertility effects unmeasured, a second opinion can help tailor decisions to your situation. Discuss pregnancy plans with a rheumatologist and the team that delivered your CAR T-cell therapy, ask whether hormone testing is appropriate, and consider registry participation. A second opinion is reasonable before conceiving, especially if you have lupus or another high-risk diagnosis. Diagnostic Detectives Network provides independent expert second opinions.\u003c\/p\u003e\n\u003c!-- ddn:faq:end --\u003e\n\n\u003ch2 id=\"source\"\u003eSource Information\u003c\/h2\u003e\n\n\u003cp\u003e\u003cstrong\u003eOriginal article title:\u003c\/strong\u003e Pregnancies in Patients with Autoimmune Disease Receiving CAR T-Cell Therapy\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eAuthors:\u003c\/strong\u003e Georg Schett, M.D., Andreas Wirsching, M.D., Tobias Rothe, Ph.D., Vanessa Visconti, M.D., Neil Kramer, M.D., Markus Metzler, M.D., Tobias Krickau, M.D., Gregory W. Kirschen, M.D., Ph.D., Daphne Landau, M.D., Caitlin Elgarten, M.D., Vikas Majithia, M.D., Ellen De Langhe, M.D., Peter Vandenberghe, M.D., Britta Maurer, M.D., Zahir Amoura, M.D., David Simon, M.D., Gerhard Krönke, M.D., Peter Gergely, M.D., Melissa Fernandes, M.D., Tamas Shisha, M.D., Brandon M. Law, M.D., Ashley Koegel, M.D., David J. Chang, M.D., Andreas Mackensen, M.D., Fabian Müller, M.D., and Melanie Hagen, M.D.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eAuthor affiliations:\u003c\/strong\u003e Friedrich-Alexander-Universität Erlangen–Nürnberg, Erlangen, Germany; Atlantic Medical Group, Morristown, NJ; University of Pennsylvania, Philadelphia; Mayo Clinic, Jacksonville, FL; Katholieke Universiteit Leuven, Leuven, Belgium; University of Bern, Bern, Switzerland; Sorbonne Université, Paris; Charité–Universitätsmedizin Berlin, Berlin; Novartis, Basel, Switzerland; Bristol Myers Squibb, Princeton, NJ; and Cabaletta Bio, Philadelphia.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003ePublication details:\u003c\/strong\u003e Published as a letter to the editor in the \u003cem\u003eNew England Journal of Medicine\u003c\/em\u003e, volume 395, number 8, pages 821–824, August 20\/27, 2026. Published online July 29, 2026, at NEJM.org. DOI: 10.1056\/NEJMc2607737. The letter appeared in the journal's correspondence section alongside other letters on unrelated topics.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eFunding and support:\u003c\/strong\u003e Supported by the Deutsche Forschungsgemeinschaft through the Leibniz Award (to Georg Schett), the CRC 1755 (CASCAID, project 02), the CRC\/TRR221, and the Clinician Scientist Program (Networks of Tissue Responses in Inflammatory Diseases and Cancer). Georg Schett is further supported by a Lupus Insight Prize from the Lupus Research Alliance. David Simon is supported by an Else Kröner Excellence Fellowship from Else Kröner–Fresenius Stiftung. Fabian Müller is supported by a grant from German Cancer Aid. Additional support came from the Staedtler Foundation and donations from the Bendel family and the Bleyl family. Disclosure forms are available with the full text of the letter at NEJM.org.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eReferences cited in the original letter:\u003c\/strong\u003e\u003c\/p\u003e\n\u003col\u003e\n  \u003cli\u003eSingh M, Wambua S, Lee SI, et al. Autoimmune diseases and adverse pregnancy outcomes: an umbrella review. \u003cem\u003eBMC Medicine\u003c\/em\u003e 2024;22:94.\u003c\/li\u003e\n  \u003cli\u003eMüller F, Taubmann J, Bucci L, et al. CD19 CAR T-cell therapy in autoimmune disease — a case series with follow-up. \u003cem\u003eNew England Journal of Medicine\u003c\/em\u003e 2024;390:687-700.\u003c\/li\u003e\n  \u003cli\u003eO'Reilly D, Jones C, Smith A, et al. Neonatal outcomes following 2 cases of maternal CAR-T therapy for high-grade B-cell lymphoma. \u003cem\u003eNeonatology\u003c\/em\u003e 2025;122:146-50.\u003c\/li\u003e\n  \u003cli\u003eJiang Q, Wang M, Wang M, et al. Successful spontaneous pregnancies and healthy neonates after dual-target CAR-T cell therapy in systemic lupus erythematosus. \u003cem\u003eArthritis \u0026amp; Rheumatology\u003c\/em\u003e 2026 February 11 (Epub ahead of print).\u003c\/li\u003e\n  \u003cli\u003eKramer N, Rosenstein ED, Cherry M. Clinical and immunologic status of a child conceived following maternal administration of CD19 CAR T-cells for systemic lupus erythematosus. \u003cem\u003eClinical and Experimental Rheumatology\u003c\/em\u003e 2026;44:1022-4.\u003c\/li\u003e\n\u003c\/ol\u003e\n\n\u003cp\u003e\u003cem\u003eThis patient-friendly article is based on peer-reviewed research. It summarizes the findings of the original letter and is not a substitute for personalized medical advice.\u003c\/em\u003e\u003c\/p\u003e","brand":"DiagnosticDetectives.Com","offers":[{"title":"Default Title","offer_id":47560938291356,"sku":null,"price":0.0,"currency_code":"USD","in_stock":true}],"url":"https:\/\/diagnosticdetectives.com\/it\/products\/pregnancy-after-car-t-cell-therapy-for-autoimmune-disease-what-14-pregnancies-tell-us","provider":"DiagnosticDetectives.Com","version":"1.0","type":"link"}