Introduction
HSC transplantation is a treatment which can be offered to treat bone marrow disease. It can be the cause of various organ complications, particularly gynaecological. Vulvovaginal GvHD is a poorly understood, under-recognised and under-diagnosed complication occurring after transplantation. Purpose Evaluation of the incidence of vulvovaginal GvHD reaction after HSC transplantation. Methods We conducted an observational, retrospective, single-center study at the Centre Henri Becquerel in Rouen. We included all patients who received an HSC allograft at the Centre Henri Becquerel and who had at least one gynaecological consultation at the centre between November 2017 and April 2024. All clinical, biological, and imaging data were analysed from computerised medical records.
Results
We included 110 patients in the study. Vulvovaginal GvHD was diagnosed in 26.36% of patients. In 59.26% of cases, GvHD was grade IV. The time to onset of GvHD was late in 96.43% of cases. In 93.10% of cases, GvHD treatments resulted in resolution of the lesions. Regarding other gynaecological complications following allograft transplantation,6.48% (n=7) of patients had menometrorrhagia; the incidence of HPV and cervical lesions was not significantly increased; 53.33% (n=16) of patients under 40 years old developed POF after transplantation; the average AMH dose was 0.80 ng/ml, and the average of antral follicle count was 1.75 for both ovaries. Patients with vulvovaginal GvHD have more sexual dysfunction such as vaginal dryness (27.85% vs 62.07%, p=0.001) and dyspareunia (21.52% vs 62.96%, p<0.001). There was no association between the presence of osteopenia/osteoporosis and the presence of genital GvHD.
Conclusion
Vulvovaginal GvHD is a poorly understood pathology and is therefore under-recognised. Other gynaecological complications may occur after HSC transplantation. It is therefore important to inform patients and offer them gynaecological follow-up appropriate to the characteristics of their disease and treatment.