Abstract
A person’s sexual and emotional life is greatly impacted after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This topic is not addressed very much by patients and caregivers. Physical, endocrine and genital chronic graft versus host disease (cGVHD)-related disorders are multiple and intertwined with psychological disorders. The Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) has issued recommendations for a better gynecological monitoring of female recipients after allo-HCT. A patient booklet was also offered to patients in the form of questions and answers to facilitate discussions between patients and caregivers and to improve the management of sexual and emotional life after transplant.
Highlights
( in terms of trust, availability, respect for intimacy, ability to listen, good distance and attention to the various factors of identification)
Age and chronic graft versus host disease (cGVHD) were significantly associated with sexual dysfunction
Intervention could halt its progress to severe fibrosis, but despite correct diagnosis and treatment, symptoms and signs may become chronic, as 12 women still had genital cGVHD at 36 months. These findings were in agreement with the observations reported previously by a French study of 32 women with genital cGVHD, which showed that early diagnosis is important to avoid severe complications [20]
Summary
The sexual problems encountered are multiple and interrelated. it is difficult to dissociate the purely physiological difficulties linked to treatments (conditioning, cGvHD, immunosuppressants, POF) and psychological difficulties (depression, anxiety, phobias, mood disorders, libido, etc.) [13,14]. In an Australian study of 442 adult allograft patients, physical and psychological dysfunctions were closely related [14]. Some caregivers and patients believe that sexual concerns take a back seat to medical treatment [15,16]. The fear of death or relapse of the hemopathy often alters libido and sexuality and impacts emotional relationships as well as the patient’s ability to project themselves into the future and into life. Fear of infection increased by the prophylactic measures to be applied on discharge and physical isolation during the transplant can lead to emotional isolation and a fear of physical contact when returning home, even with relatives. The announcement of sterility or ovarian insufficiency induced by the transplant treatments can have an impact on subsequent sexual life. ( in terms of trust, availability, respect for intimacy, ability to listen, good distance and attention to the various factors of identification)
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