Washington (ISJ): A new research study indicates bone marrow transplant or stem cell transplant could affect sexual health of recipient, both men and women. The study published in Blood, the journal of the American Society of Hematology, confirm chronic graft-versus-host disease (GVHD), a serious complication that occurs when donor cells attack the recipient?s cells, as a potential source of sexual dysfunction. The study is one of the longest and most inclusive to date evaluating sexual well-being in stem cell transplant survivors using rigorous well-validated sexual function assessment tools.
Stem Cell Transplant is an increasingly effective form of treatment for patients with blood cancer such as leukemia, lymphoma, and myeloma. The procedure, which involves transplantation of cells taken either from a patient?s own blood or bone marrow (autologous transplantation) or from a matched donor (allogeneic transplantation), effectively "replaces" damaged cells with healthy cells. While procedure once resulted in high mortality, survival rates have steadily increased, prompting research seeking to study and maximize survivors? quality of life.
"Thanks to improved transplant survival rates, we have now been able to focus our efforts on examining how the procedure affects key aspects of recipients' overall quality of life, including sexual health," said lead study author Dr. F. Lennie Wong of City of Hope in Duarte, California. "Previous findings point to the unfortunate fact that, while recipients may physically recover, their sexual health might not rebound as much or as quickly. Data have 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."
A team of researchers led by senior author Dr. Smita Bhatia surveyed 277 adult patients (152 men and 125 women; average age 48) who underwent stem cell transplantation at City of Hope for blood cancer between February 2001 and January 2005 about their sexual activity. Analysis of the questionnaire results confirmed previous studies in demonstrating a definitive impact of stem cell transplantation on survivors? post-transplant sexual activity.
During the three-year post-transplant analysis period, the percentage of men who self-reported being ?sexually active? (at least once in the preceding month) declined 7 percentage points, with 61 percent of men reporting sexual activity pre-transplant and 54 percent reporting activity post-transplant. The opposite ? a 15 percentage point increase in sexually active individuals ? was observed in women, with 37 percent reporting sexual activity pre-transplant and 52 percent reporting activity post-transplant.
Investigators observed a nearly 18 percent decline in sexual function in men surveyed who had received total body radiation. The same group also reported an approximate 32 percent decrease in sexual satisfaction, a 26 percent decrease in sexual behavior/experience, a 26 percent decrease in quality of orgasm, and 17 percent decrease in sex drive/relationship since their transplant. Despite these effects in men, radiation had no such reported effect in women, an effect that investigators hypothesize may be explained by inherent physiologic differences in the pathogenesis of sexual dysfunction among men and women.
Women in comparison suffered significantly worse effects overall, despite the fact that their sexual activity increased over the three-year survey period. Investigators concluded that this increase in activity may be explained by a corresponding improvement in female psychological quality of life post transplant.
Researchers conclude nearly half of stem cell transplant survivors are sexually inactive at three years post transplant and suggest patients may benefit from speaking with their doctors about sex.
"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; 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," said Dr. Wong.
(Source: American Society of Hematology press release)