Overcoming psychosocial and developmental barriers to blood and marrow transplantation (BMT) in an adolescent/young adult (AYA) transgender patient with chronic myelogenous leukemia

Pediatr Hematol Oncol. 2014 Nov;31(8):765-7. doi: 10.3109/08880018.2014.909914. Epub 2014 May 22.

Abstract

Adolescents/young adults (AYAs) afflicted with cancer face unique barriers to potentially standard curative therapies, such as blood and marrow transplantation (BMT). Transgender AYAs face additional barriers and there is a dearth of published literature regarding their oncology-related experience. We present the case of an AYA male-to-female (MTF) transgender patient on cross-sex hormone therapy, with a history of Chronic Myelogenous Leukemia (CML) and significant psychosocial barriers, which initially served as a barrier to BMT at two different centers; we modified our standard consent and education process and was able to successfully proceed with BMT and subsequently cure her CML. Despite unique challenges, AYA and transgender patients with significant psychosocial barriers may achieve successful outcomes with BMT. Research is needed regarding guidelines for cross-sex hormone therapy administration for patients undergoing BMT and other issues, which may be unique to the transgender experience.

Keywords: adolescent/young adult (AYA); barriers; blood and marrow transplant (BMT); cancer; psychosocial; transgender.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adolescent
  • Bone Marrow Transplantation / psychology*
  • Female
  • Gonadal Steroid Hormones / administration & dosage
  • Graft vs Host Disease / psychology
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / psychology
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy*
  • Male
  • Patient Compliance / psychology
  • Patient Education as Topic
  • Psychology
  • Quality of Life / psychology
  • Social Adjustment
  • Social Discrimination / psychology
  • Transgender Persons / psychology*
  • Transplantation Conditioning
  • Treatment Outcome
  • Young Adult

Substances

  • Gonadal Steroid Hormones