Clinical guidelines for gynecologic care after hematopoietic SCT. Report from the international consensus project on clinical practice in chronic GVHD

Tirri, Brigitte Frey; Häusermann, Peter; Bertz, Hartmut; Greinix, Hildegard; Lawitschka, Anita; Schwarze, C. P.; Wolff, Daniel; Halter, Joerg; Dörfler, Daniela; Moffat, Rebecca

doi:10.1038/bmt.2014.242

Cited by 53 publications

(84 citation statements)

References 82 publications

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“…POF is characterized by symptoms of oestrogen deficiency, such as hot flushes, night sweats, mood disorders, sleep disorders, lack of concentration, arthralgia, impaired sexual function and loss of reproductive potential, that have a negative impact on quality of life [4, 7]. …”

Section: Methodsmentioning

confidence: 99%

“…Lack of oestrogens at an early age prevents the development of secondary sex characteristics, increases the risk for osteoporosis, cognitive impairment and cardiovascular disease, frequently observed in women after HSCT [7, 13]. …”

Section: Methodsmentioning

confidence: 99%

“…Female genital cGVHD can cause complete vaginal obstruction resulting in haematocolpos or hematometra, which can manifest as cyclic pain and amenorrhea in women taking HT or as difficulty in voiding in case of vulvar adhesions [7]. Actually, female genital cGVHD is well-recognized clinical condition, with a precise assessment and scoring form recently developed [19].…”

Section: Methodsmentioning

confidence: 99%

“…Actually the main gynaecological complications of HSCT are represented by: premature ovarian failure (POF), thrombocytopenia-associated menorrhagia, genital symptoms or sexual problems in course of chronic Graft Versus Host Disease (cGVHD), osteoporosis, secondary solid tumours due to immunosuppressive drugs to treat cGVHD and severity of cGVHD [7, 8], and fertility and pregnancy issues. Nonetheless, these last issues remain poorly investigated in the international literature with only some reports of successful pregnancies [9].…”

Section: Introductionmentioning

confidence: 99%

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Reproductive issues in patients undergoing Hematopoietic Stem Cell Transplantation: an update

et al. 2016

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In 1963 George Mathé announced to the world that he had cured a patient of leukaemia by means of a bone-marrow transplant. Since than much progress has been made and nowadays Hematopoietic Stem Cell Transplantation (HSCT) is considered the most effective treatment of numerous severe haematological diseases. Gynaecological complications in HSCT women represent a serious concern for these patients, but often underestimated by clinicians in the view of Overall Survival. The main gynaecological complications of HSCT are represented by: premature ovarian failure (POF), thrombocytopenia-associated menorrhagia, genital symptoms or sexual problems in course of chronic GVHD (cGVHD), osteoporosis, secondary solid tumours due to immunosuppressive drugs to treat cGVHD and severity of cGVHD, and fertility and pregnancy issues. In particular fertility-related issues are always more relevant for patients, whose life expectation is constantly growing up after HSCT.Thus, taking care of a patient undergoing HSCT should primarily include gynaecological evaluation, even before conditioning regimen or chemotherapy for the underlying malignancy, as, in our opinion, it is of great importance to ensure a complete diagnostic work-up and intervention options to guarantee maximum reproductive health and a better quality of life in HSCT women.The present review aims at describing principal features of the aforementioned gynaecological complications of HSCT, and to define, on the basis of current international literature, a specific protocol for the prevention, diagnosis, management and follow-up of gynaecological complications of both autologous and heterologous transplantation, before and after the procedure.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reproductive issues in patients undergoing Hematopoietic Stem Cell Transplantation: an update

et al. 2016

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“…52 The recommendations include local corticosteroids (class IV) as the mainstay therapy for genital changes. Surgical intervention may be necessary in severe cases (Table 1).…”

Section: Methodsmentioning

confidence: 99%

Sexual health in hematopoietic stem cell transplant recipients

Mewawalla

Stratton

et al. 2015

Cancer

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Hematopoietic stem cell transplantation (HSCT) plays a central role in patients with malignant and, increasingly, nonmalignant conditions. As the number of transplants increases and the survival rate improves, long-term complications are important to recognize and treat to maintain quality of life. Sexual dysfunction is a commonly described but relatively often underestimated complication after HSCT. Conditioning regimens, generalized or genital graft-versus-host disease, medications, and cardiovascular complications as well as psychosocial problems are known to contribute significantly to physical and psychological sexual dysfunction. Moreover, it is often a difficult topic for patients, their significant others, and health care providers to discuss. Early recognition and management of sexual dysfunction after HSCT can lead to improved quality of life and outcomes for patients and their partners. This review focuses on the risk factors for and treatment of sexual dysfunction after transplantation and provides guidance concerning how to approach and manage a patient with sexual dysfunction after HSCT.

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