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Obstet Gynecol. 2013 Feb;121(2 Pt 2 Suppl 1):424-7. doi: http://10.1097/AOG.0b013e318270ecd3.

Management of uterine bleeding during hematopoietic stem cell transplantation.

Author information

  • 1Department of Obstetrics and Gynecology, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Abstract

BACKGROUND:

Hematopoietic stem cell transplant is an effective treatment strategy for a variety of hematologic disorders, but patients are at risk for dysfunctional coagulation and abnormal bleeding. Gynecologists are often consulted before transplant for management of abnormal uterine bleeding, which may be particularly challenging in this context.

CASE:

A premenopausal woman with MonoMAC (a rare adult-onset immunodeficiency syndrome characterized by monocytopenia and Mycobacterium avium complex infections resulting from mutations in GATA2, a crucial gene in early hematopoiesis) presented with pancytopenia, evolving leukemia, and recent strokes, necessitating anticoagulation. During preparation for hematopoietic stem cell transplant, she experienced prolonged menorrhagia requiring transfusions. Surgical therapy was contraindicated, and medical management was successful only when combined with balloon tamponade.

CONCLUSION:

Balloon tamponade may be a potentially life-saving adjunct to medical therapy for control of uterine hemorrhage before hematopoietic stem cell transplant.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00018044 NCT00923364.

PMID:
23344397
[PubMed - indexed for MEDLINE]
PMCID:
PMC3798064
Free PMC Article
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