Fertility and sexual function in long‐term survivors of haematological malignancy: using patient‐reported outcome measures to assess a neglected area of need in the late effects clinic

Greaves, Paul; Sarker, Shah-Jalal; Chowdhury, Kashfia; Johnson, Rachel C.; Matthews, Janet; Matthews, Rebecca; Smith, Matthew; Korszun, Ania; Gribben, John G.; Lister, T. Andrew

doi:10.1111/bjh.12651

Cited by 55 publications

(65 citation statements)

References 38 publications

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“…7 Previous studies have reported differences in sexual health and its predictive factors between male and female survivors, 3,[7][8][9] indicating that sexual outcomes need to be analyzed within sexes.…”

Section: 11mentioning

confidence: 99%

“…3,7,8 Those studies relied on questionnaires that focused on 1 or a few overarching questions. In 1 study that used a larger array of questions to compare sexual functioning in childhood cancer survivors with that in a group of healthy controls, more frequent low sexual interest, low sexual satisfaction, feeling sexually unattractive, orgasmic difficulty during intercourse, and a lower total number of sexual partners were reported among the survivors.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4] The use of prophylactic cranial irradiation as a part of ALL therapy is associated with a risk of anterior pituitary dysfunction. Gonadotropin deficiency is associated with cranial irradiation at doses of >22 grays (Gy).…”

Section: Introductionmentioning

confidence: 99%

“…12 The only study that analyzed the association between exposure to cancer therapy and sexual dysfunction did not report an association. 7 Previous studies have reported differences in sexual health and its predictive factors between male and female survivors, 3,[7][8][9] indicating that sexual outcomes need to be analyzed within sexes.…”

Section: Introductionmentioning

confidence: 99%

“…Poorer sexual health has been reported among male survivors who had a diagnosis of central nervous system (CNS) tumors compared with those who had other cancer types 9 and among survivors who received treatment during adolescence compared with those who were younger at the time of treatment. 12 The only study that analyzed the association between exposure to cancer therapy and sexual dysfunction did not report an association.7 Previous studies have reported differences in sexual health and its predictive factors between male and female survivors, 3,[7][8][9] indicating that sexual outcomes need to be analyzed within sexes.To better understand the extent and quality of the sexual problems faced by adult male survivors of childhood ALL, we conducted a study on the first large cohort of adult long-term survivors (10 years) of childhood ALL at the Helsinki University Central Hospital. A well validated and comprehensive self-report measure of sexual function was used, and the results were compared with those from an age-matched and sex-matched control group.…”

mentioning

confidence: 99%

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Sexual function in male long‐term survivors of childhood acute lymphoblastic leukemia

Haavisto

Henriksson

Heikkinen

et al. 2016

Cancer

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BACKGROUND: Infertility, poor semen quality, and gonadal dysfunction are well recognized long-term sequelae in male survivors of childhood acute lymphoblastic leukemia (ALL). However, few studies have investigated adult sexual functioning in these survivors. METHODS: The authors studied 52 male survivors of childhood ALL at a median age of 28.5 years (range, 25-38 years) 10 years after diagnosis. In addition, 56 men without a history of cancer were recruited for an age-matched control group. The participants completed the Derogatis Interview for Sexual Functioning self-report. To analyze predictive factors for sexual dysfunction, variables assessing sociodemographic background, antileukemia treatment, testicular size, laboratory variables from current serum and semen samples, self-reported depressive symptoms, and self-reported physical functioning were included in multiple regression analyses. RESULTS: ALL survivors had significantly poorer sexual functioning, as measured by the Derogatis Interview for Sexual Functioning self-report, compared with the control group. Survivors had a similar frequency of sexual fantasies, autoerotic acts, and full erection during these activities as the control group, but they had less frequent sexual activity with a sexual partner, poorer self-rated orgasms, and lower satisfaction with their sex life. Predictive factors for poorer sexual functioning were depressive symptoms, the absence of a relationship, and, to a lesser extent, testicular size as an indication of gonadal damage from childhood antileukemia therapy. Older survivors experienced a deeper decline in sexual functioning compared with men in the control group. CONCLUSIONS: Decline in sexual functioning at an early adult age can be regarded as 1 of the late effects of childhood cancer. Monitoring these survivors' sexual health is indicated. Cancer 2016;122:2268-76. V C 2016 American Cancer Society.KEYWORDS: childhood leukemia, late effects, long-term survivors, predictive factors, sexual function. INTRODUCTIONLong-term male survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for impaired fertility, poor semen quality, and gonadal dysfunction because of gonadotoxic treatments, such as testicular irradiation and high cumulative doses of cyclophosphamide, used as part of their antileukemia therapy.1-4 The use of prophylactic cranial irradiation as a part of ALL therapy is associated with a risk of anterior pituitary dysfunction. Gonadotropin deficiency is associated with cranial irradiation at doses of >22 grays (Gy). If untreated, it is known to cause increased risk of abdominal obesity, hypertension, dyslipidemia, low bone mineral density, low energy expenditure, and slow walking.5 During the latest decades, cranial irradiation has largely been omitted from the treatment of ALL, 6 and alkylating agents have decreasingly been used. To a certain extent, this has reduced the risks among leukemia survivors. However, few studies have paid attention to adult sexual functioning and its determinants among long...

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Section: 11mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Sexual function in male long‐term survivors of childhood acute lymphoblastic leukemia

Haavisto

Henriksson

Heikkinen

et al. 2016

Cancer

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Sexual Dysfunction

Schover

2017

Holland‐Frei Cancer Medicine

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Overview Sexual problems related to cancer are usually caused by physiological damage from treatment, but are exacerbated by psychosocial issues such as poor communication, relationship conflict, or preexisting sexual dysfunction. Sexual dysfunction affects almost two‐thirds of the estimated 14 million cancer survivors in the United States, including over 50% of those treated for pelvic or breast cancers and at least 25% for other sites. Optimal treatment is multidisciplinary, addressing both physical damage and coping skills. If a committed relationship exists, it is best to include the partner in education and intervention.

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Remission after CAR T‐cell therapy: Do lymphoma patients recover a normal life?

Perthus,

Colin,

Charton

et al. 2024

HemaSphere

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Chimeric antigen receptor T cells (CAR T cells) can induce prolonged remission in a substantial subset of patients with relapse/refractory lymphoma. However, little is known about patients' life after CAR T‐cell therapy. We prospectively assessed the multidimensional recovery of lymphoma patients in remission, before leukapheresis, before CAR T‐cell infusion, and 3, 6, and 12 months thereafter. Validated tools were used to measure lymphoma‐related and global health‐related quality of life (HRQoL; Functional Assessment of Cancer Therapy‐Lymphoma [FACT‐Lym] and EQ‐5D‐5L), cognitive complaint (FACT‐Cognition), fatigue (FACIT‐Fatigue subscale), psychological status (Hospital Anxiety and Depression Scale, Post‐Traumatic Check List Scale), and sexuality (Relationship and Sexuality Scale). Beyond 12 months of remission, we also surveyed physical, professional, sexual, and general life status. At 3, 6, and 12 months, 53, 35, and 23 patients were evaluable, respectively. Improvement in lymphoma‐related HRQoL was clinically relevant at 3, 6, and 12 months with a mean change from baseline of 10.9 (95% confidence interval [CI]: 5.8; 16.1), 12.2 (95% CI: 4.2; 20.1), and 11.72 (95% CI: 2.06; 21.38), respectively. Improvement in global HRQoL, fatigue, and anxiety was clinically relevant, but 20%–40% of patients experienced persistent fatigue, psychological distress, and cognitive complaints over time. Beyond 12 months after CAR T cells, 81.8% of 22 evaluable patients were satisfied with their daily life. Physical activity, professional, sexual, and global well‐being had returned to prediagnosis levels in nearly half of the patients. We found an improvement in HRQoL after CAR T‐cell therapy including anxiety, depression, sexual satisfaction, and general well‐being. However, not all patients recover a “normal life.” Further research is needed to determine which patients are at risk of quality‐of‐life impairment to improve recovery after CAR T‐cell infusion.

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Fertility and sexual function in long‐term survivors of haematological malignancy: using patient‐reported outcome measures to assess a neglected area of need in the late effects clinic

Cited by 55 publications

References 38 publications

Sexual function in male long‐term survivors of childhood acute lymphoblastic leukemia

Sexual function in male long‐term survivors of childhood acute lymphoblastic leukemia

Sexual Dysfunction

Remission after CAR T‐cell therapy: Do lymphoma patients recover a normal life?

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