Quality of life, reproduction and sexuality after stem cell transplantation with partially T-cell-depleted grafts and after conditioning with a regimen including total body irradiation

Abstract

Thirty-four men and 36 women (median age 43 and 45 years, respectively) underwent stem cell transplantation (SCT) for acute leukaemia in first complete remission or chronic myelogenous leukaemia in first chronic phase between 1981 and 2001 from HLA-identical siblings. The conditioning regimen included TBI and all grafts were partially depleted of T cells. Changes in quality of life (QOL), reproduction and sexuality were studied using a questionnaire, and the previously given information related to these problems was assessed. In addition, endocrine status was assessed and semen analysis was performed. After SCT, patients reported less energy (n ¼ 50) and a deterioration in the job situation (n ¼ 31). Patients experienced a negative change in sexual relations (n ¼ 41). Important problems of sexual dysfunction were vaginal dryness in women (n ¼ 19) and erectile dysfunction in men (n ¼ 16). None of the patients was fertile based on their gonadotrophin levels, sperm concentrations and reproductive outcomes. Women experienced climacteric symptoms (n ¼ 24). Quality of life was negatively influenced by these changes. One-fifth of the patients were not satisfied with the information given with regard to reproduction, premature menopause and sexual problems.

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

“…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%). At year 1, women in the current study reported significantly more problems compared to the previous study in terms of difficulties with orgasm (24 vs 72%), vaginal dryness (49 vs 78%) and painful intercourse (35 vs 61%).…”

“…Quality of life studies have shown that sexual dysfunction and dissatisfaction are frequently reported among BMT patients, although with varying rates. [1][2][3][4][5][6] Despite the apparent prevalence of sexual issues in BMT survivors, there have been few longitudinal studies examining sexual functioning in this population. Most studies of sexual functioning have used short follow-up periods (3-12 months) or have been cross-sectional in nature.…”

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,[22][23][24][25][27][28][29] Five studies were prospective designs, with follow-up periods from 1 to 10 years. 6,8,9,27,30 Case-matched controls were used in four studies.…”

The effect of administration order of BU and CY on engraftment and toxicity in HSCT mouse model

“…13 In spite of improved techniques and new drug invention in recent years, HSCT is still a procedure that is associated with high rate of morbidity and mortality. GVHD, 14 hypothyroidism, 15 cataract, 16 veno-occlusive disorder, 17 interstitial pneumonia, 18 hemorrhagic cystitis 19 and decrement of the quality of life 20 are the most common post-HSCT complications. It is believed that the conditioning regimen plays a crucial role in the development of these complications.…”