Pregnancy After CAR T Shows Early Promise

No autoimmune disease flares occurred across 14 pregnancies after CAR T-cell therapy, with 8 healthy babies born and 5 pregnancies ongoing.

By
Mouj Hijazi
October 7, 2026
3 min

The Medicine Maker

Overview

An early report described 14 pregnancies in 13 patients who had received CAR T-cell therapy for autoimmune disease. No autoimmune disease flares were reported during pregnancy; eight healthy infants had been born at the time of reporting, with five pregnancies ongoing and one electively terminated for reasons unrelated to autoimmune disease.

Background

Autoimmune diseases disproportionately affect women of childbearing age, while disease activity and immunosuppressive treatment can complicate pregnancy. CD19-directed CAR T-cell therapy targets disease-associated B cells and has produced sustained drug-free remission in some patients. Pregnancy after treatment raises questions about disease relapse without ongoing immunosuppression and whether prolonged maternal B-cell depletion could affect the fetus or newborn. Evidence on pregnancy after CAR T-cell therapy remains limited.

Data Highlights

Measure	Reported finding
Pregnancies and patients	14 pregnancies in 13 patients
Underlying autoimmune disease	8 systemic lupus erythematosus; 2 systemic sclerosis; 1 each idiopathic inflammatory myositis, systemic sclerosis-rheumatoid arthritis overlap syndrome, and antiphospholipid syndrome
Pregnancy status at reporting	8 healthy births; 5 pregnancies ongoing; 1 elective termination unrelated to autoimmune disease
Time from CAR T-cell therapy to conception	1–42 months
Disease activity and treatment	No flares during pregnancy; all but one patient remained drug-free or received only prophylactic hydroxychloroquine
Birth outcomes	Median gestational age 37 weeks; median birth weight 2,995 g; Apgar scores described as reassuring
Infant immune findings and follow-up	No CAR T cells detected in newborns; CD19-positive B-cell numbers and IgG levels within normal ranges; follow-up 1–18 months, with normal development reported in all eight infants

Key Findings

The cohort comprised 14 spontaneous pregnancies in 13 patients; none used assisted reproductive technologies.
No autoimmune disease flares were reported during pregnancy, including among the eight patients with systemic lupus erythematosus.
One patient developed preeclampsia with changes in proteinuria and renal-retention variables; renal biopsy showed no active lupus nephritis.
Eight infants had been born at the time of reporting. No CAR T cells were detected in newborns, and reported CD19-positive B-cell counts and IgG levels were within normal ranges.
All eight infants had normal development reported during follow-up of 1–18 months; one infant had influenza at eight months, and no other infections were reported.
The researchers called for pregnancy registries and further studies of the effects of lymphodepletion and CAR T-cell treatment on fertility.

Conclusion

In this small report, pregnancies after CAR T-cell therapy for autoimmune disease were not accompanied by reported disease flares, and early outcomes among the eight infants born were described as favorable. Larger registries and further fertility research are needed, as the authors noted.