Effects of Management of Heavy Menstrual Bleeding of Patients Undergoing Haploidentical Hematopoietic Stem Cell Transplantation

Objective: Heavy menstrual bleeding (HMB) was an underestimated bleeding complications of hematopoietic stem cell transplantation (HSCT). The study aims to investigate the benefits of menstrual management in women undergoing HSCT. Methods: Patients who had undergone HSCT in the Gynecological Endocrinology Clinic of Peking University People's Hospital were included in ten years. The data of hematology and menstruation of all participants had been collected. The management methods of intervention group include GnRHa, COC or low-dose mifepristone. Patients who did not receive management were included in the control group. Results: There were 112 patients included in the intervention group and 218 patients included in the control group. There were 90.0% of patients presenting with HMB before HSCT. In the control group, 83.5% of patients experienced uterine bleeding in the LAFR, while only 22.3% did in the intervention group. The rate of recurrent uterine bleeding after HSCT was significantly higher in the control group (50.9% vs. 17.9%, P < 0.001). Patients who did not undergo menstrual management had a higher risk of uterine bleeding than those who did (OR = 18.12, P < 0.001). Conclusion: Menstrual management significantly reduces the incidence of uterine bleeding in HSCT patients and acts as a protective factor against uterine bleeding in the LAFR.