Endocrine Abstracts

Haematopoietic stem cell transplantation (HSCT), also known as bone marrow transplantation, is a potentially curative therapy mainly indicated in malignant and non-malignant bone marrow disorders. It has resulted in improved survival for patients at the cost of long-term complications. Endocrine and metabolic disorders are the most prevalent sequelae following bone marrow transplantation, primarily caused by powerful conditioning chemotherapy associated with total body irradiation. Primary hypogonadism, as evidenced by secondary amenorrhoea, is treated with hormone replacement therapy in post-pubertal females, aiming to achieve physiological serum levels of oestradiol with due attention to appropriate endometrial protection. In males, onset of primary hypogonadism may be insidious post HSCT and delay in testosterone replacement may result in poorer quality of life (from hypogonadal symptoms), anaemia and osteoporosis at an early age. Long-term surveillance is therefore not only focused at identifying hypogonadal symptoms but also at biochemical and bone density assessment. HSCT recipients are at an increased risk of metabolic complications in the long term. Surveillance strategies post HSCT should therefore empower patients to adopt healthy lifestyle choices (dietary, exercise, smoking cessation and alcohol consumption) and focus on obesity prevention. Regular screening for dyslipidaemia, hypertension and diabetes allows for early detection and prompt treatment.