A prospective study of the effects of high-dose chemotherapy and bone marrow transplantation on sexual function in the first year after transplant

Abstract

Summary:We have initiated a long-term prospective study of sexual function using the Derogatis Interview for Sexual Functioning (DISF) for males and females. 8 This self-adminisPatients undergoing high-dose chemotherapy and bone marrow transplantation (BMT) may experience a vartered questionnaire has a number of advantages. It is widely used, easy to administer and well validated in cancer iety of abnormalities of psychological and physical function including sexual dysfunction. However, no study patients. 9 It evaluates fantasy, arousal, experience, orgasm and desire in addition to giving an overall score of sexual has prospectively evaluated whether there is an association between sexual dysfunction and BMT. In a prefunction. In our initial study, we evaluated 30 patients pre-BMT and found that sexual dysfunction was commonly vious study in which we analyzed the sexual function of 30 patients immediately before transplant, we found seen. 10 Since then the sample size has been increased to 50 and we have prospectively resurveyed these patients at 3 that nearly half of all patients had sexual dysfunction using the Derogatis Interview for Sexual Functioning months, and in some cases, 12 months post-BMT. We also attempted to correlate these results with possible demofor males and females. The findings of the pilot study led us to hypothesize that the incidence of sexual dysgraphic risk factors for sexual dysfunction, as well as with the medical complications of the transplant. function would not be significantly altered by BMT; we performed a prospective study designed to test this hypothesis. In this study a further 20 patients about to undergo BMT were surveyed, making a total of 50.Patients and methods Thirty-one of 38 survivors were reanalyzed 3-6 months after transplant. The major finding of the study is thatPatients and definitions the incidence of sexual dysfunction is unchanged 3 months after transplant (48 vs 36%, P = NS). The mean All patients between the ages of 16 and 65 years undergoing bone marrow transplantation between July 1994 and total score on the DISF was decreased by 7.5 points but this was also not significant. A preliminary analysis of November 1995 at Hahnemann University Hospital were approached to participate in a prospective study of sexual 16 patients surveyed at 12 months post-BMT suggests little change in sexual function between 3 and 12 months function. The sexual function of the first 30 patients pre-BMT has been reported in detail. 10 The majority of patients post-BMT. We conclude that in the first 12 months after high-dose chemotherapy and BMT the pretreatment received regimens containing busulfan and cyclophosphamide. Patients with breast cancer received cisplatinum and difficulties remain.

Sexual functioning in patients undergoing bone marrow transplantation: a longitudinal study

“…First, sexual dysfunction in the form of lack of desire, body image problems and physical functioning is a salient issue for patients undergoing BMT. This finding is consistent with previous studies that have examined sexual functioning specifically [7][8][9][10] or as part of a larger quality of life assessment in BMT recipients. [1][2][3][4][5][6] Compared to a previous study 10 of sexual functioning that included baseline, 1-and 3-year time points, our participants reported more sexual difficulties pretransplantation in terms of orgasm (14 vs 46% for women; 4 vs 13% for men) vaginal dryness (30 vs 49%), erectile dysfunction (13 vs 33%) and painful intercourse for women (14 vs 29%).…”

“…Most studies of sexual functioning have used short follow-up periods (3-12 months) or have been cross-sectional in nature. [7][8][9] Among those studies that have been published, only one went beyond a 1-year follow-up. 10 In that study, sexually active survivors completed measures of sexual activity, sexual problems (i.e., arousal, orgasm) and sexual satisfaction 1-and 3-years post transplant.…”

Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction

“…Sexual problems were reported by 24% of treated Hodgkin's disease patients studied by Kornblith et al (1992) and less interest in sexual activity was reported by 20% of a similar group studied by Fobair et al (1986). Rates of sexual dysfunction following BMT have been described in between 20 and 50% of patients (Hjermstad and Kassa, 1995;Marks et al, 1997). Testosterone is important for determining sexual desire and erectile function and will therefore impact on sexual activity.…”

The impact of hematopoietic stem cell transplantation on sexuality: a systematic review of the literature

“…[6][7][8][9][22][23][24][25][26][27][28][29][30][31] The majority of these, 4 each, came from the United States and the United Kingdom, 2 from Germany and 1 each from Canada, Ireland, The Netherlands and Finland.…”

“…6,8,9,27,30 Case-matched controls were used in four studies. 8,27,28,30 Eight studies focused primarily on sexuality and sexual dysfunction, [6][7][8][9]22,26,27,29 and five studies focused primarily on QOL/late effects, with a secondary focus on sexual function. [23][24][25]28,30,31 The type of HSCT was allogeneic in five studies, autologous in two and both allogeneic and autologous in six studies.…”