Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, NSW, Australia.
Br J Haematol. 2016 Feb;172(4):592-601. doi: 10.1111/bjh.13872. Epub 2015 Dec 21.
Four hundred and twenty-one adult allogeneic haematopoietic stem cell transplant (HSCT) survivors participated in a cross-sectional study to assess sexual dysfunction and infertility post-transplant. Survey instruments included the Sydney Post-Blood and Marrow Transplant (BMT) Survey, Functional Assessment of Cancer Treatment (FACT) - BMT, the Depression, Anxiety, Stress Scales (DASS 21), the Chronic Graft-versus-Host Disease (cGVHD) Activity Assessment- Patient Self Report (Form B), the Lee cGVHD Symptom Scale and The Post-Traumatic Growth Inventory. Most HSCT survivors reported sexual difficulties (51% of males; 66% of females). Men reported erectile dysfunction (79%) and decreased libido (61·6%) and women reported loss of libido (83%), painful intercourse (73%) and less enjoyment of sex (68%). Women also commonly reported vaginal dryness (73%), vaginal narrowing (34%) and vaginal irritation (26%). Woman had much higher rates of genital cGvHD than men (22% vs. 5%). Age and cGVHD were significantly associated with sexual dysfunction. Few survivors had children following transplant (3·3%). However, for those of reproductive age at HSCT, 22% reported trying to conceive, with 10·3% reporting success. This study is the largest to date exploring sexual function in survivors of allo-HSCT. This data provides the basis for health service reform to better meet the needs of HSCT survivors, including evidence to support counselling and education both pre- and post-transplant.
421 名成年异基因造血干细胞移植（HSCT）幸存者参与了一项横断面研究，以评估移植后性功能障碍和不孕。调查工具包括悉尼血液和骨髓移植（BMT）后调查、癌症治疗功能评估（FACT）-BMT、抑郁、焦虑和压力量表（DASS 21）、慢性移植物抗宿主病（cGVHD）活动评估-患者自我报告（B 型）、李 cGVHD 症状量表和创伤后成长清单。大多数 HSCT 幸存者报告存在性功能障碍（男性占 51%；女性占 66%）。男性报告勃起功能障碍（79%）和性欲降低（61.6%），而女性报告性欲降低（83%）、性交疼痛（73%）和性快感降低（68%）。女性还经常报告阴道干燥（73%）、阴道狭窄（34%）和阴道刺激（26%）。女性生殖器 cGVHD 的发生率明显高于男性（22%比 5%）。年龄和 cGVHD 与性功能障碍显著相关。移植后很少有幸存者有孩子（3.3%）。然而，对于那些在 HSCT 时处于生育年龄的人，22%报告试图怀孕，其中 10.3%报告成功。这项研究是迄今为止探索 allo-HSCT 幸存者性功能的最大研究。这些数据为卫生服务改革提供了依据，以更好地满足 HSCT 幸存者的需求，包括为移植前后的咨询和教育提供证据支持。
