专家共识
ENGLISH ABSTRACT
造血干细胞移植患者的妇产科管理专家共识
中华医学会妇产科学分会绝经学组
造血干细胞移植患者的妇产科管理专家共识专家组
作者及单位信息
·
DOI: 10.3760/cma.j.cn112141-20211225-00749
Gynecologic care for women undergoing hematopoietic stem cell transplantation: Chinese expert consensus
Menopause Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association
Expert Group of Chinese Expert Consensus on Gynecologic Care for Women Undergoing Hematopoietic Stem Cell Transplantation
Authors Info & Affiliations
Menopause Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association
Expert Group of Chinese Expert Consensus on Gynecologic Care for Women Undergoing Hematopoietic Stem Cell Transplantation
·
DOI: 10.3760/cma.j.cn112141-20211225-00749
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摘要

造血干细胞移植(HSCT)是根治多种造血及非造血系统良恶性疾病的重要方法。女性HSCT患者的妇产科管理包括生殖系统炎症、HPV感染及子宫颈病变、异常子宫出血、生殖器移植物抗宿主病及早发性卵巢功能不全(POI)。HSCT前的管理应重点关注HPV感染及子宫颈癌筛查情况,进行月经管理、卵巢功能评估及卵巢功能保护咨询。HSCT后至造血重建期,由于血小板计数低下,月经管理成为主要问题。HSCT后的远期,待患者整体健康恢复后,应定期进行妇产科相关检查与评估,重点关注HPV感染及子宫颈癌筛查情况、POI的诊治及康复后生育指导。本共识是根据国内外的研究结果和相关指南,结合临床实践经验,经过充分讨论后而制定,旨在促使国内多学科医师更好地管理和诊治HSCT患者的相关妇产科问题,从而提高患者的生命质量。

引用本文

中华医学会妇产科学分会绝经学组,造血干细胞移植患者的妇产科管理专家共识专家组. 造血干细胞移植患者的妇产科管理专家共识[J]. 中华妇产科杂志,2022,57(06):401-406.

DOI:10.3760/cma.j.cn112141-20211225-00749

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造血干细胞移植(hematopoietic stem cell transplantation,HSCT)是通过大剂量放化疗等预处理方案,清除HSCT适用疾病患者体内的疾病异常细胞,并移植自体或异体的造血干细胞,使之重建正常的造血和免疫功能,从而根治多种造血及非造血系统良恶性疾病的重要方法。HSCT的具体过程包括清髓性或非清髓性预处理、造血干细胞输注、植活及造血重建。每年全世界接受HSCT治疗者超过5万例,2019年我国HSCT总例数超过1万例 1
随着HSCT技术进步,HSCT患者的生存率提高、生存时间延长,女性HSCT患者的妇产科相关问题受到广泛关注,如生殖系统炎症、HPV感染及子宫颈病变、异常子宫出血、生殖器移植物抗宿主病(graft-versus-host disease,GVHD)及医源性早发性卵巢功能不全(premature ovarian insufficiency,POI)。血液病患者常规化疗后POI的发生率为65%~84%;育龄期女性HSCT患者接受清髓性化疗POI的发生率接近100% 2,受孕率<1% 3。青春期前的女性HSCT患者白消安化疗和全身放疗(total body irradiation,TBI)后自发性青春期发动(非药物诱导)及自发性月经的比例仅为40%~60% 4
本共识的专家组根据国内外的研究结果和相关指南,结合临床实践经验,经过充分讨论后制定了本共识,旨在促使国内多学科医师更好地管理和诊治HSCT患者的相关妇产科问题,提高其生命质量。
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备注信息
A
杨欣,北京大学人民医院妇产科,北京 100044,Email: mocdef.aabnis3002_gnaynix
B
郁琦,中国医学科学院北京协和医院妇产科,北京 100730,Email: mocdef.3ab61dmiquy
C

中华医学会妇产科学分会绝经学组, 造血干细胞移植患者的妇产科管理专家共识专家组. 造血干细胞移植患者的妇产科管理专家共识[J]. 中华妇产科杂志, 2022, 57(6): 401-406. DOI: 10.3760/cma.j.cn112141-20211225-00749.

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