Endocrine dysfunction and surveillance following hematopoietic stem cell transplantation: A clinical practice guideline update
DOI:
https://doi.org/10.46765/2675-374X.2026v7n1e368Keywords:
Hematopoietic stem cell transplantation, Endocrine late effects, Survivorship, Screening, Fertility preservationAbstract
Endocrine disorders are the most common long-term complications after hematopoietic stem cell transplantation (HSCT). They can affect growth, thyroid, adrenal, gonadal function, bone health, and metabolism. In 2021, the Brazilian Society of Bone Marrow Transplantation (SBTMO) published guidelines for endocrine follow-up after HSCT, which were updated in 2023, providing practical support for monitoring and managing transplant survivors. Since then, these guidelines have been reinforced, with the main shift being toward personalized monitoring strategies. In this approach, the intensity and frequency of endocrine surveillance are adjusted according to each survivor’s treatment exposures and overall risk, rather than following fixed screening schedules. The scope of follow-up has also expanded to include fertility preservation and transition to adult care. Rather than introducing entirely new recommendations, current practice reflects a refinement of existing approaches. Even so, many recommendations still rely on moderatequality evidence, underscoring the need for prospective multicenter studies.
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Copyright (c) 2026 Adriana Aparecida Siviero-Miachon, Paulo Alonso Garcia Alves-Junior, Renato Fraietta, Angela Maria Spinola-Castro, Maria Alice Neves Bordallo
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