Pilot study of a multimodal intervention to enhance sexual function in survivors of hematopoietic stem cell transplantation

Cancer. 2018 Jun 1;124(11):2438-2446. doi: 10.1002/cncr.31333. Epub 2018 Mar 14.


Background: Although sexual dysfunction is common after hematopoietic stem cell transplantation (HCT), interventions to address sexual function are lacking.

Methods: We conducted a pilot study to assess the feasibility and preliminary efficacy of a multimodal intervention to address sexual dysfunction in allogeneic HCT survivors. Transplant clinicians screened HCT survivors ≥3 months post-HCT for sexual dysfunction causing distress. Those who screened positive attended monthly visits with a trained transplant clinician who: 1) performed an assessment of the causes of sexual dysfunction; 2) educated and empowered the patient to address his or her sexual concerns; and 3) implemented therapeutic interventions targeting the patient's needs. Feasibility was defined as having approximately 75% of patients who screened positive agreeing to participate and 80% attending at least 2 intervention visits. We administered the Patient-Reported Outcomes Measurement Information System (PROMIS) sexual function and satisfaction measure, the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT), and the Hospital Anxiety and Depression Scale (HADS) to evaluate sexual function, quality of life (QOL), and mood, respectively, at baseline and 6 months postintervention.

Results: Approximately 33.1% of patients (50 of 151 patients) screened positive for sexual dysfunction causing distress and 94.0% (47 of 50 patients) agreed to participate, with 100% attending 2 intervention visits. Participants reported improvements in satisfaction (P<.0001) and interest in sex (P<.0001), as well as orgasm (P<.0001), erectile function (P<.0001), vaginal lubrication (P = .0001), and vaginal discomfort (P = .0005). At baseline, approximately 32.6% of participants were not sexually active, compared with 6.5% after the intervention (P = .0005). Participants reported improvement in their QOL (P<.0001), depression (P = .0002), and anxiety (P = .0019).

Conclusions: A multimodal intervention to address sexual dysfunction integrated within the transplant clinic is feasible with encouraging preliminary efficacy for improving sexual function, QOL, and mood in HCT survivors. Cancer 2018;124:2438-46. © 2018 American Cancer Society.

Keywords: hematologic malignancies; hematopoietic stem cell transplantation (HCT); sexual dysfunction; supportive care; survivorship care; transplantation survivors.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cancer Survivors / psychology*
  • Cancer Survivors / statistics & numerical data
  • Combined Modality Therapy / methods
  • Feasibility Studies
  • Female
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Patient Reported Outcome Measures
  • Patient Satisfaction / statistics & numerical data
  • Pilot Projects
  • Quality of Life*
  • Sexual Behavior / physiology
  • Sexual Behavior / psychology
  • Sexual Behavior / statistics & numerical data
  • Sexual Dysfunction, Physiological / etiology
  • Sexual Dysfunction, Physiological / physiopathology
  • Sexual Dysfunction, Physiological / psychology
  • Sexual Dysfunction, Physiological / rehabilitation*
  • Stress, Psychological / etiology
  • Stress, Psychological / physiopathology
  • Stress, Psychological / psychology
  • Stress, Psychological / rehabilitation*
  • Treatment Outcome