A prospective study of female genital chronic graft-versus-host disease symptoms, signs, diagnosis and treatment

Acta Obstetricia Et Gynecologica Scandinavica
Eva Smith KnutssonKarin Sundfeldt

Abstract

Female genital chronic graft-versus-host disease (cGvHD) is a complication of allogeneic hematopoietic cell transplantation (alloHCT) for blood malignancies. Unattended inflammation and fibrosis in the vulva and vagina may lead to total vaginal stenosis. The course and treatment of genital cGvHD was observed in this population-based prospective study. Women (n = 41) receiving alloHCT in 2005-10 were examined before and at 3, 6, 9, 12, 18, 24, 30 and 36 months post-transplant. Vulvovaginal signs were documented, National Institutes of Health clinical scores were calculated, and women completed questionnaires on symptoms, the Female Sexual Distress Scale and the Beck Depression Inventory. Local immunosuppressive treatment was given weekly. Genital cGvHD was diagnosed in 27 women (incidence 56% at 12 months; 66% at 36 months); extragenital cGvHD was found in 21/27. The most common signs at diagnosis were red and white spots, reticular white lines, fissures, synechiae and telangiectasia; symptoms included dryness, itching, dyspareunia, pain or no symptoms. Thirteen women were treated on a schedule of tacrolimus and clobetazol ointments. Although some signs progressed during treatment, only two women developed total stenosis. At 36 ...Continue Reading

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Citations

Jul 19, 2019·Climacteric : the Journal of the International Menopause Society·M JacobsonW L Wolfman
Sep 22, 2020·Seminars in Diagnostic Pathology·Sara C ShalinKatelynn K Campbell
Oct 3, 2021·British Journal of Haematology·Noa G Holtzman, Steven Z Pavletic
Dec 29, 2021·Acta Obstetricia Et Gynecologica Scandinavica·Eva Smith KnutssonMats Brune

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