Gynecological Complications in Long-term Survivors After Allogeneic Hematopoietic Cell Transplantation-a Single-center Real-life Cross-sectional Study

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2022 Oct 3

PMID 36186762

Authors

Huina Su

Xinyu Zhou

Yanli Zhao

Yue Lu

Deyan Liu

Janping Zhang

Xin Yang

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Hematopoietic stem cell transplantation (HCT) is a treatment for hematopoietic diseases. However, most cured female patients may suffer from premature ovarian insufficiency (POI) after HCT, which is mainly caused by the pre-HCT conditioning regimen. Hence, this study aims to explore the impact of HCT treatment on reproductive and ovarian functions in female survivors.

Methods: A total of 55 female participants under the age of 40, who underwent HCT and met the inclusion criteria were enrolled. Data related to blood disease, menstruation, and fertility in the 3 years following HCT were collected.

Results: The involved patients received transplantation at different age stages, ranging from 8 to 37. All patients, except those with aplastic anemia (AA; 5/55), received a myeloablative conditioning regimen, usually modified total body irradiation/cyclophosphamide (TBI/Cy; 25/55) or modified Busulfan/cyclophosphamide (Bu/Cy; 23/55). Among women (42/55) who menstruated before HCT, 16.67% (7/42) had a spontaneous menstrual relapse and 83.3% (35/42) had amenorrhea after HCT. 72.7% (40/55) could be regarded as having POI. This proportion included 100% (25/25) of women aged 21-40 at the time of HCT, 62.5% (15/24) of those aged 11-20, and 0% (0/6) of those ≤10 years old. Patients with AML were more likely to have POI (95.7%). Patients aged ≤10 years (0%) or 11-20 years (16.7%) at the time of HCT were less likely to have moderate to severe menopause than those 21-40 years old (44%).

Conclusion: The prevalence of POI following HCT was high and POI was associated with age, conditioning regimen, and type of blood disease.

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