Randomized Trial of a Sexual Dysfunction Intervention for Hematopoietic Stem Cell Transplant Survivors

Areej El-Jawahri

MD

Massachusetts General Hospital

Project Term: July 1, 2019 - June 30, 2024

Project Summary

The use of Hematopoietic stem cell transplantation (HCT) as a potentially curative treatment strategy for blood cancer has increased over the last decade with more than 20,000 transplants performed in the United States each year. Sexual health problems are common among the rapidly increasing number of HCT survivors, and such problems negatively impact their quality of life, mood, and intimate relationships. Over half of HCT survivors are under 45 years of age – much younger on average than survivors of most other cancers. Therefore, this group experiences more severe sexual health concerns, resulting in a wider range of biologic, interpersonal, psychological, and social problems. Despite this, no interventions have been developed to address sexual health problems in this population. Therefore, there is a critical need to develop and test innovative interventions that comprehensively address the multiple factors affecting sexual function in HCT survivors. We recently completed a small study of a multimodal intervention to address sexual health problems in HCT survivors. Study participants attended monthly visits with trained study nurse practitioners who 1) performed in-depth assessments of the causes of the patients’ sexual health problems; 2) educated, normalized, and empowered patients to address their sexual health issues; and 3) implemented therapeutic interventions targeting the patients’ individual sexual health needs. We demonstrated that the intervention was feasible and led to significant improvements in patients’ satisfaction and interest in sex and sexual health and function. Notably, 6 of 10 patients who were not sexually active prior to the study became sexually active afterwards. Patients also reported clinically significant improvement in their quality of life. The goal of this project is to conduct a randomized clinical trial of 230 HCT survivors to rigorously demonstrate the efficacy of the multimodal intervention to address sexual health problems in HCT survivors, enhancing patients’ sexual function and their interest in sexual activity. We will also test whether the intervention improves patients’ quality of life and reduces their depression and anxiety symptoms. In addition to its potential to improve HCT survivorship, this intervention can easily be adapted and utilized to address the sexual health concerns of other cancer survivors. Therefore, this work represents an important opportunity to improve the quality of life and survivorship care of patients with blood cancer.