VULVO-Vaginal Chronic Graft-Versus-Host Disease Assessment: A Single-Center Prospective Observational Study

Area of Science:

• Hematology
• Oncology
• Gynecology

Background:

• Vulvovaginal chronic graft-versus-host disease (vv-cGvHD) is an underrecognized complication following allogeneic hematopoietic stem cell transplantation (HSCT).
• It can significantly impact sexual function, quality of life, and long-term patient morbidity.
• Limited prospective data exist regarding systematic gynecological assessment for vv-cGvHD.

Purpose of the Study:

• To evaluate the 1-year incidence and clinical features of vv-cGvHD in female patients post-HSCT.
• To assess the impact of vv-cGvHD using standardized gynecological examinations and patient-reported outcomes.

Main Methods:

• Prospective, observational, single-center study involving female patients alive and relapse-free at day +100 post-HSCT.
• Standardized gynecological examinations performed at baseline, day +100, 6 months, and 12 months.
• Patient-reported outcomes collected via a symptom-focused questionnaire.

Main Results:

• The 1-year cumulative incidence of vv-cGvHD was 30% (12/41 patients), with 6 cases of grade 1 and 6 of grade 2.
• Half of affected patients had isolated genital involvement.
• Median onset was 6 months post-transplant; other organ GvHD was the only associated factor (p=0.02).
• Topical corticosteroids and hyaluronic acid were effective treatments, preventing progression to severe disease.

Conclusions:

• vv-cGvHD occurs with considerable frequency in HSCT recipients.
• Systematic screening and established management protocols are essential for this patient population.