Female long-term survivors after allogeneic hematopoietic stem cell transplantation: evaluation and management.
Female long-term survivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) incur a significant burden of late effects. Genital graft-versus-host disease (GVHD), human papillomavirus (HPV) reactivation, ovarian failure and infertility, sexual dysfunction, and osteoporosis are concerns that can significantly impact quality of life. This review examines the risk, pathogenesis, clinical presentation, and implications of these common complications. Recommendations are provided for evaluation and management of these late effects and other obstetric and gynecologic issues that may arise in this patient population.
Program in Reproductive and Adult Endocrinology, Eunice Kennedy Schriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892-1109, USA.
Dana
D
Shanis
Melissa
M
Merideth
Tajana Klepac
TK
Pulanic
Bipin N
BN
Savani
Minoo
M
Battiwalla
Pamela
P
Stratton
D005260:Female; D006086:Graft vs Host Disease / Q000150:complications / Q000209:etiology* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007247:Infertility, Female / Q000150:complications* / Q000628:therapy; D010024:Osteoporosis / Q000150:complications* / Q000628:therapy; D030361:Papillomavirus Infections / Q000150:complications* / Q000628:therapy / Q000821:virology; D017741:Survivors; D013997:Time Factors; D014184:Transplantation, Homologous