Table 10.

Screening of the most frequent endocrine complications after allo-HSCT

Thyroid Disorder	- TSH, free serum T4 at 6 months and yearly
	- Clinical thyroid examination yearly
	- Sonogram if clinical anomaly
	- If abnormalities are detected, consider referral to an endocrinologist
Gonad dysfunction/Fertility	1. before allo-HSCT: conservation must be proposed as possible:
	- Man: Sperm collection. After chemotherapy, it is possible if patient is not azoospermic.
	- Female: ovary or oocyte freezing ; ovarian blocking by Gn-RH analogs
	- Prepubertal: freezing of testicle pulp and ovarian tissu sample.
	2. after allo-HSCT (first months): contraception is necessary (see Table 2)
	3. after allo-SCT (second period):
	- Woman: hormonal assessment and substitution indicated in 6–12 months. Gynecologic evaluation yearly. Be careful between vaginal GVHD and menopausal symptoms.
	- For male, dosage of testosterone if symptoms warrant and consider referral to specialist.
	4. If pregnancy is discussed: 2 years between allo-HSCT and pregnancy is the minimum required. Patient should be referred to specialist in assisted reproductive technologies/oncofertility.
Osteoporosis	- Compensate a potential deficiency of calcium and vitamin D, especially if steroids.
	- Screen and treat other causes of osteoporosis (hyperthyroidism, hyperparathyroidism, hypogonadism)
	- Dual photon densitometry (DEXA): if possible before and at least 1, 5 and 10 year after HSCT.
	- Biphosphonate therapy if osteopenia or osteoporoses are established and if steroid therapy >7.5 mg/day is prescribed more than 3 months