Abstract Presenter: Ann-Christin Pecher, MD, Senior Physician in Rheumatology, University Hospital Tuebingen, Germany
Abstract Title: Hormone Levels of Female Patients with SLE after Anti-CD19 CAR T-cell Treatment Do Not Suggest an Impaired Ovarian Reserve
Abstract Session: Abstracts: Reproductive Issues in Rheumatic Disorders (1844-1849), 8–9:30 a.m., Monday, November 9
What is your abstract about?
Dr. Pecher: Our study investigates the impact of anti-CD19 chimeric antigen receptor T cell (CAR-T) therapy on ovarian function in women with SLE. We longitudinally assessed anti-Müllerian hormone (AMH) and several reproductive hormones before and approximately 12 months after CAR-T therapy in 13 women with severe, treatment-refractory systemic lupus erythematosus (SLE). Overall, we found no evidence of a clinically relevant decline in ovarian reserve, with AMH remaining stable after treatment. Although follicle-stimulating hormone (FSH) increased slightly, this was not accompanied by a decline in AMH. These findings are encouraging, particularly because CAR-T therapy is increasingly being considered for young women with severe SLE, for whom fertility and future family planning are highly relevant.
Why did you decide to investigate this topic?
Dr. Pecher: SLE predominantly affects women during their reproductive years, and both the disease itself and conventional immunosuppressive therapies can negatively affect fertility. Cyclophosphamide, in particular, is well known for its potential gonadotoxic effects. CAR-T therapy offers the possibility of sustained, drug-free remission, but it requires lymphodepletion that usually includes cyclophosphamide. We therefore wanted to understand whether this treatment could have an impact on ovarian reserve and reproductive endocrinology. We felt that this is an important aspect of CAR-T safety that has received comparatively little attention so far.
What are you working on next related to this research?
Dr. Pecher: Our next steps are to continue longitudinal follow-up of these patients to better understand the long-term effects of CAR-T therapy on ovarian function and, importantly, reproductive outcomes. Larger cohorts and longer follow-up will be needed to confirm these initial findings. We are also interested in incorporating additional markers of ovarian reserve and reproductive function, including ultrasound-based parameters such as antral follicle count, as well as menstrual and fertility outcomes.
What excites you most about your work?
Dr. Pecher: What excites me most is the possibility that CAR-T therapy could fundamentally change the long-term treatment paradigm for young women with severe SLE. Achieving sustained remission without ongoing immunosuppression could potentially have major implications not only for disease control, but also for quality of life, family planning, and reproductive health. Being able to investigate these aspects alongside the immunological effects of CAR-T therapy is particularly rewarding.
What are you most looking forward to at ACR Convergence 2026 in Orlando?
Dr. Pecher: I am most looking forward to meeting colleagues working in the field of rheumatology and CAR-T therapy, exchanging ideas, and discussing the latest developments in this rapidly evolving area. I am also excited to learn from other researchers and to gain new perspectives that may help us further develop our work on CAR-T therapy and reproductive health in patients with rheumatic diseases.
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