BACKGROUND: Genital chronic graft-versus-host disease (GVHD) is a frequent but underdiagnosed complication of allogeneic stem-cell transplantation impairing quality of life. METHODS: We identified 32 female patients with genital chronic GVHD (cGVHD) who underwent allogeneic hematopoietic stem-cell transplantation in our center between 2000 and 2010 and who were followed after transplantation in a specialized gynecological consultation. Pre- and posttransplantation clinical data and detailed acute and cGVHD data were collected. All patients received the same local treatment for genital lesions. RESULTS: At presentation, most patients complained about vaginal dryness and dyspareunia with impairment in sexual activity. Fifty percent of patients had grade I genital lesions and 50% had grade II or III lesions. Patients seen later in gynecological consultation had more severe lesions than patients seen early after transplantation. At the time of diagnosis, most patients had other cutaneous or mucous localizations of cGVHD. In most cases, lesions were stabilized or decreased with local steroids and estrogen treatment, and most patients could resume sexual activity. Treatment was more efficient in patients with mild lesions than in others. CONCLUSIONS: Genital cGVHD should be systematically searched for in women who have received allogeneic hematopoietic stem-cell transplantation in an early specialized consultation, especially in case of other cutaneous or mucous localizations of cGVHD. Local treatment associating steroids and estrogen seemed to prevent further evolution of grade I genital lesions and to avoid surgical treatment.
BACKGROUND: Genital chronic graft-versus-host disease (GVHD) is a frequent but underdiagnosed complication of allogeneic stem-cell transplantation impairing quality of life. METHODS: We identified 32 female patients with genital chronic GVHD (cGVHD) who underwent allogeneic hematopoietic stem-cell transplantation in our center between 2000 and 2010 and who were followed after transplantation in a specialized gynecological consultation. Pre- and posttransplantation clinical data and detailed acute and cGVHD data were collected. All patients received the same local treatment for genital lesions. RESULTS: At presentation, most patients complained about vaginal dryness and dyspareunia with impairment in sexual activity. Fifty percent of patients had grade I genital lesions and 50% had grade II or III lesions. Patients seen later in gynecological consultation had more severe lesions than patients seen early after transplantation. At the time of diagnosis, most patients had other cutaneous or mucous localizations of cGVHD. In most cases, lesions were stabilized or decreased with local steroids and estrogen treatment, and most patients could resume sexual activity. Treatment was more efficient in patients with mild lesions than in others. CONCLUSIONS: Genital cGVHD should be systematically searched for in women who have received allogeneic hematopoietic stem-cell transplantation in an early specialized consultation, especially in case of other cutaneous or mucous localizations of cGVHD. Local treatment associating steroids and estrogen seemed to prevent further evolution of grade I genital lesions and to avoid surgical treatment.
Authors: Madan H Jagasia; Hildegard T Greinix; Mukta Arora; Kirsten M Williams; Daniel Wolff; Edward W Cowen; Jeanne Palmer; Daniel Weisdorf; Nathaniel S Treister; Guang-Shing Cheng; Holly Kerr; Pamela Stratton; Rafael F Duarte; George B McDonald; Yoshihiro Inamoto; Afonso Vigorito; Sally Arai; Manuel B Datiles; David Jacobsohn; Theo Heller; Carrie L Kitko; Sandra A Mitchell; Paul J Martin; Howard Shulman; Roy S Wu; Corey S Cutler; Georgia B Vogelsang; Stephanie J Lee; Steven Z Pavletic; Mary E D Flowers Journal: Biol Blood Marrow Transplant Date: 2014-12-18 Impact factor: 5.742
Authors: Paul A Carpenter; Carrie L Kitko; Sharon Elad; Mary E D Flowers; Juan C Gea-Banacloche; Jörg P Halter; Flora Hoodin; Laura Johnston; Anita Lawitschka; George B McDonald; Anthony W Opipari; Bipin N Savani; Kirk R Schultz; Sean R Smith; Karen L Syrjala; Nathaniel Treister; Georgia B Vogelsang; Kirsten M Williams; Steven Z Pavletic; Paul J Martin; Stephanie J Lee; Daniel R Couriel Journal: Biol Blood Marrow Transplant Date: 2015-03-31 Impact factor: 5.742
Authors: Eric J Chow; Lynnette Anderson; K Scott Baker; Smita Bhatia; Gregory M T Guilcher; Jennifer T Huang; Wendy Pelletier; Joanna L Perkins; Linda S Rivard; Tal Schechter; Ami J Shah; Karla D Wilson; Kenneth Wong; Satkiran S Grewal; Saro H Armenian; Lillian R Meacham; Daniel A Mulrooney; Sharon M Castellino Journal: Biol Blood Marrow Transplant Date: 2016-01-21 Impact factor: 5.742
Authors: Susan R Rose; Vincent E Horne; Jonathan Howell; Sarah A Lawson; Meilan M Rutter; Gylynthia E Trotman; Sarah D Corathers Journal: Nat Rev Endocrinol Date: 2016-04-01 Impact factor: 43.330
Authors: Karen L Syrjala; Hélène Schoemans; Jean C Yi; Shelby L Langer; Ahona Mukherjee; Lynn Onstad; Stephanie J Lee Journal: Transplant Cell Ther Date: 2020-09-29
Authors: Leslie R Schover; Marleen van der Kaaij; Eleonora van Dorst; Carien Creutzberg; Eric Huyghe; Cecilie E Kiserud Journal: EJC Suppl Date: 2014-05-29