Underdiagnosed and Overlooked: a Scoping Review of Vulvovaginal Graft-Versus-Host Disease after Allogeneic Stem Cell Transplantation
Vanhoutte Zira, Lavaert Sarah, 2025
Allogeneic stem cell transplantation (allo-SCT) is a life-saving treatment for malignant and non-malignant diseases. However, it often causes complications, including graft-versus-host disease (GvHD). Vulvovaginal GvHD (vvGvHD) is a chronic manifestation of GvHD in which the immune cells from the donor attack the healthy genital tissue of the recipient. Despite the significant impact of vvGvHD, it remains an underdiagnosed and underreported complication of allo-SCT.
This condition presents with symptoms such as pain, dryness, itching, and genital scarring, which can affect the daily life, sexual health, and psychological well-being of the patients. In some cases, it leads to severe complications like vaginal narrowing or adhesions. Importantly, some patients present asymptomatic, which underscores the importance of routine screening for early detection. Local immunosuppressants are an effective treatment, especially in mild cases of vvGvHD. Severe cases often require surgery, followed by long-term management to prevent recurrence.
By analysing and summarizing the available literature, this scoping review highlights the importance of thorough care, which includes routine examinations, personalized treatment, psychosocial assessment, and long-term follow-up. It is imperative to tailor the care in children and young adults according to their age. This scoping review is a good starting point for future research, highlighting both the current knowledge and the gaps in knowledge of vvGvHD.
This scoping review emphasizes the need for more awareness of vvGvHD among both healthcare providers and patients. By advocating for routine screening and early intervention, it addresses a significant gap in women's health after allo-SCT. The study also underscores the importance of integrating physical and emotional care, as vvGvHD affects patients' sexual health and mental well-being. The societal value lies in improving the quality of life for women and girls impacted by this overlooked complication, while advocating for the renewal of clinical guidelines to ensure better care and outcomes.
| Promotor | Hans Verstraelen |
| Opleiding | Geneeskunde |
| Domein | Dermatologie |
| Kernwoorden | vulvovaginal graft-versus-host disease, stem cell transplantation Vulvovaginal Graft-vs-Host Disease Allogeneic Stem Cell Transplantation |