Reproductive late effects after hematopoietic stem cell transplant in pediatric, adolescent, and young adult cancer survivors

Leslie C. Appiah, Molly Moravek, Holly Hoefgen, Seth Rotz, Krista Childress, Jill Samis, Janie Benoit, Kenny Rodriguez-Wallberg, Antoinette Anazodo

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Reproductive late effects after hematopoietic stem cell transplant can have a significant impact on cancer survivors’ quality of life. Potential late effects include gonadal insufficiency, genital graft-versus-host disease, uterine injury, psychosexual dysfunction, and an increased risk of breast and cervical cancer in patients treated with total body irradiation. Despite guidelines, screening and treatment are not standardized among at-risk patients. Provider barriers include lack of knowledge of at-risk therapies and evidenced-based guidelines. Patient barriers include a reluctance to report symptoms and lack of awareness of treatment options. System barriers include inefficient implementation of screening tools and poor dissemination of guidelines to providers who serve as the medical home for survivors. This review guides the clinician in identifying and managing reproductive late effects after hematopoietic stem cell transplant to improve outcomes.

Original languageEnglish
Article numbere30551
JournalPediatric Blood and Cancer
Volume70
Issue numberS5
DOIs
StatePublished - Sep 2023

Keywords

  • adolescent
  • genital graft-versus-host disease
  • gonadal insufficiency
  • hematopoietic stem cell transplant
  • hormone therapy
  • pediatric
  • radiation-induced breast cancer
  • radiation-induced uterine injury
  • reproductive late effects
  • young adult (AYA) cancer

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