Blood and bone marrow stem cell transplants can be lifesaving procedures for patients with blood cancers such as leukemia, lymphoma and myeloma. But they can take a heavy physical and emotional toll.
City of Hope researchers have long been concerned about the effect of stem cell transplants on patients' overall quality of life, and they recently focused their attention on one specific aspect — patients' sexual well-being.
What they found was sobering. Preparations for stem cell transplants and complications associated with the procedure can indeed lead to diminished sexual health for both men and women. The research also confirmed, among both genders a connection between reduced sexual health and graft-versus-host disease and, for men only, between reduced sexual health and total body radiation.
The study is considered one of the best to date on the effects of sexual well-being among stem cell transplant survivors.
"Previous findings point to the unfortunate fact that, while recipients may physically recover, their sexual health might not rebound as much or as quickly,” said lead author F. Lennie Wong, Ph.D., associate research scientist in the Department of Population Sciences at City of Hope, as quoted in the American Society of Hematology news release. “Data has been limited to this point, prompting us to take a closer look at this issue in a larger, more diverse group of autologous and allogeneic transplant survivors over an extended period."
The study, published in Blood, the journal of the American Society of Hematology, included 152 men and 125 women, with a median age of 48. All patients underwent stem cell transplants at City of Hope between 2001 and 2005 and were followed up for three years.
Participants completed two questionnaires that assessed specific areas of sexual function and sexual satisfaction, and a third that assessed the overall quality of life.
The data on men and women were markedly different in some respects. During the three-year post transplant period, the percentage of men who reported being "sexually active" fell 7 percentage points, from 61 percent pretransplant to 54 percent post-transplant. The percentage of women who reported being "sexually active" during this time increased by 15 percentage points, from 37 percent reporting pretransplant to 52 percent post-transplant.
The differences continued when assessing the impact of total body radiation. The sexual function of men who underwent the procedure declined by almost 18 percent, researchers found; women who underwent the procedure reported no such effect.
Although the women reported an increase in sexual activity over the three-year period, researchers found that they experienced significantly worse sexual effects than men.
Overall, researchers said, nearly half of stem cell transplant survivors are sexually inactive three years after their transplant. They suggested that patients should have an open conversation with their doctors about their sexual health.
"It is not often that the transplant team and patient will have a conversation about how this procedure could impact their sex life, even after recovery," said Wong in the news release. "However, we hope these findings will help encourage patients and their doctors to openly discuss concerns related to sexual dysfunction and address them with specialists who can help."
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