Schimmer A D, Ali V, Stewart A K, Imrie K, Keating A
Autologous Blood and Marrow Transplant Long-Term Follow-up Research Unit, The Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada.
Biol Blood Marrow Transplant. 2001;7(5):279-83. doi: 10.1053/bbmt.2001.v7.pm11400950.
Although endocrine dysfunction has been reported in survivors of allogeneic bone marrow transplantation (alloBMT), data for autologous BMT (autoBMT) recipients are lacking. Because information on male potency in particular is scanty, we prospectively assessed male sexual function after autoBMT. We identified 16 men who were < or =50 years of age at the time of evaluation and disease free for at least 6 months after autoBMT. Nine had Hodgkin's disease, 4 had acute myelogenous leukemia, and 3 had non-Hodgkin's lymphoma. Blood samples were assayed for luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone. Patients were surveyed with a modified version of the Pyschosocial Adjustment to Illness Scale regarding erectile dysfunction and loss of interest in sexual activities. Seventy five percent of the men reported normal interest in sexual activities and 87.5% reported normal erectile function; however, 4 of 16 reported a moderate loss of interest in sexual activities, and another 2 of 16 reported frequent loss of erectile function. All 4 men with decreased libido and both men with impaired erectile function had Hodgkin's disease. Fourteen (88%) of 16 patients had an elevated FSH level, 7 (47%) of 15 had elevated LH, and 6 (38%) of 16 had decreased testosterone levels. Decreased testosterone levels correlated with a moderate or total loss of libido (P = .008) and a diagnosis of Hodgkin's disease (P = .01). Thus, after transplantation, most men have abnormal levels of gonadotrophins. Decreased levels of testosterone and symptoms of sexual dysfunction correlated with a diagnosis of Hodgkin's disease and may be related to the induction and salvage therapy received prior to autoBMT.
尽管已有报道称异基因骨髓移植（alloBMT）幸存者存在内分泌功能障碍，但自体骨髓移植（autoBMT）受者的数据尚缺。由于关于男性性功能尤其是这方面的信息匮乏，我们对autoBMT后的男性性功能进行了前瞻性评估。我们确定了16名在评估时年龄≤50岁且autoBMT后至少6个月无疾病的男性。其中9例患有霍奇金病，4例患有急性髓性白血病，3例患有非霍奇金淋巴瘤。检测血样中的促黄体生成素（LH）、促卵泡生成素（FSH）和睾酮。采用疾病心理社会适应量表的修订版对患者进行有关勃起功能障碍和性活动兴趣丧失的调查。75%的男性报告性活动兴趣正常，87.5%报告勃起功能正常；然而，16人中有4人报告性活动兴趣中度丧失，另有2人报告频繁出现勃起功能丧失。所有4例性欲减退的男性以及2例勃起功能受损的男性均患有霍奇金病。16例患者中有14例（88%）FSH水平升高，15例中有7例（47%）LH升高，16例中有6例（38%）睾酮水平降低。睾酮水平降低与性欲中度或完全丧失相关（P = 0.008），与霍奇金病诊断相关（P = 0.01）。因此，移植后大多数男性的促性腺激素水平异常。睾酮水平降低和性功能障碍症状与霍奇金病诊断相关，可能与autoBMT前接受的诱导和挽救治疗有关。
