Gynecologic care after hematopoietic cell transplantation: a call to action to include gynecologists in the transplant team.
Gynecologic care after hematopoietic cell transplantation: a call to action to include gynecologists in the transplant team.
复制标题
造血细胞移植后的妇科护理：呼吁采取行动，将妇科医生纳入移植团队。
DOI：
10.1038/bmt.2014.247
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发表时间：
2015
影响因子：
4.8
通讯作者：
Stratton,P
中科院分区：
文献类型：
--
作者：
Stratton,P
More than 30 different cancers, chronic diseases and hematologic conditions are currently treated by hematopoietic cell transplant resulting in about 50000 transplants a year. 1, 2 Cell-transplant physicians have successfully improved survivorship by decreasing the rate of relapse, improving engraftment, preventing or treating infections and screening for secondary cancers. 3 A continuing challenge is chronic GVHD (cGVHD) and its long-term sequelae. 4 The pathophysiology of cGVHD remains one of the most poorly understood complications of hematopoietic cell transplantation (HCT). Thus, for now, the focus remains on early recognition of cGVHD and then initiating treatment in hopes of minimizing its long-term effects. In addition, the transplant process results in many physiological changes including gonadal failure that alter the quality of life. These changes differ depending on the gender and age of the patient.In this monthLs journal, Dr Frey Tirri et al. 5 have accomplished something unusual in the care of women after cell transplant. Their regional cell transplant organization in Switzerland, Germany and Austria has developed a consensus statement for the gynecologic care of women. Their paper is a comprehensive review of the current knowledge regarding gynecologic health and provides recommendations for post-transplant gynecologic care with the goal to diagnose, to prevent and then treat female genital cGVHD. They set forth the importance of fertility preservation counseling, options for hormonal treatment for premature ovarian failure and for treatment of diminished libido. They also address the assessment of pediatric patients not only for signs of cGVHD but also for pubertal status. If these young girls do not produce estrogen after transplant, this lack of estrogen can prevent the development of secondary sex characteristics.
