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Cancer. 2016 Jul 15;122(14):2268-76. doi: 10.1002/cncr.29989. Epub 2016 May 12.

Sexual function in male long-term survivors of childhood acute lymphoblastic leukemia.

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Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
National Supervisory Authority for Welfare and Health, and Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland.
Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
Division of Hematology-Oncology and Stem Cell Transplantation, Children´s Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.



Infertility, poor semen quality, and gonadal dysfunction are well recognized long-term sequelae in male survivors of childhood acute lymphoblastic leukemia (ALL). However, few studies have investigated adult sexual functioning in these survivors.


The authors studied 52 male survivors of childhood ALL at a median age of 28.5 years (range, 25-38 years) ≥ 10 years after diagnosis. In addition, 56 men without a history of cancer were recruited for an age-matched control group. The participants completed the Derogatis Interview for Sexual Functioning self-report. To analyze predictive factors for sexual dysfunction, variables assessing sociodemographic background, antileukemia treatment, testicular size, laboratory variables from current serum and semen samples, self-reported depressive symptoms, and self-reported physical functioning were included in multiple regression analyses.


ALL survivors had significantly poorer sexual functioning, as measured by the Derogatis Interview for Sexual Functioning self-report, compared with the control group. Survivors had a similar frequency of sexual fantasies, autoerotic acts, and full erection during these activities as the control group, but they had less frequent sexual activity with a sexual partner, poorer self-rated orgasms, and lower satisfaction with their sex life. Predictive factors for poorer sexual functioning were depressive symptoms, the absence of a relationship, and, to a lesser extent, testicular size as an indication of gonadal damage from childhood antileukemia therapy. Older survivors experienced a deeper decline in sexual functioning compared with men in the control group.


Decline in sexual functioning at an early adult age can be regarded as 1 of the late effects of childhood cancer. Monitoring these survivors' sexual health is indicated. Cancer 2016;122:2268-76. © 2016 American Cancer Society.


childhood leukemia; late effects; long-term survivors; predictive factors; sexual function

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