IMR Press / EJGO / Volume 31 / Issue 6 / pii/1630990947622-811685774

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with S.O.G.

Case Report
Severe vaginal chronic graft-versus-host disease (GVHD): two cases with late onset and literature review
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1 Department of Obstetrics and Gynaecology, Hôpital Civil de Charleroi, Charleroi (Belgium)
Eur. J. Gynaecol. Oncol. 2010, 31(6), 703–704;
Published: 10 December 2010

Female genital graft-versus-host disease (GVHD) occurs after allogenic stem cell transplantation (SCT) in 25% of long-term survivors. To date, 28 severe cases with hematocolpos requiring surgery have been documented. We report two cases of severe gynecological GVHD. Although most of the vaginal GVH disease cases occurred within two years after oncologic treatment, our two cases highlight the possibility of a very long onset. We also confirmed that hormonal replacement therapy does not protect against synechia and that corticoid treatment has a good therapeutic value in recurrence after surgery. In conclusion, women with SCT experience a high risk of vaginal GVHD that could impair quality of life and sexual function. These cases pinpointed the importance of very long-term gynecological follow-up in order to diagnose early symptoms. To date, only early therapy with local corticoid application might reduce symptoms and development of severe genital GVHD. We support systematic use of topical corticoid therapy in severe cases even after surgery because of the high incidence of recurrence.
Chronic graft-versus-host disease
Vaginal stenosis
Stem cell transplantation
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