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The following is a summary of “Genital graft versus host disease in women after allogeneic hematopoietic stem cell transplantation – a single center experience,” published in the January 2025 issue of Hematology by Goldsher et al. 

Chronic graft-versus-host disease (GVHD) is a common complication of allogeneic hematopoietic stem cell transplantation (HSCT), affecting 25–66% of women. Genital GVHD is an underdiagnosed condition that can significantly impair quality of life (QoL). 

Researchers conducted a retrospective study to describe the prevalence and management of genital GVHD following HSCT. 

They included women who underwent allogeneic HSCT at a single Bone Marrow Transplantation Unit between 2015 and 2020 and were evaluated at a specialized Vulvo-Vaginal Clinic. Diagnosis and severity of genital GVHD followed National Institute of Health (NIH) recommendations, with treatment options including topical treatments and surgical interventions. 

The results showed that 19.4% of the 36 patients were diagnosed with genital GVHD. Patients with genital GVHD were older than those without (58.42 vs 47.48 years, P = 0.02), and 85.71% had concurrent multi-organ chronic GVHD. Genital GVHD was symptomatic in 71.42%, with 57.1% of cases classified as NIH grade 3. Topical treatments were initiated for all patients, and 1 required surgery. Genitourinary syndrome of menopause (GSM) was diagnosed in 100% of patients with genital GVHD and 58.62% without (P = 0.08). Clinical follow-up adherence was 43.85%. 

Investigators concluded that genital GVHD should be part of chronic GVHD evaluations after HSCT. It was linked to advanced age, systemic GVHD, and limited follow-up.

Source: link.springer.com/article/10.1007/s00277-025-06224-1