ABSTRACT Background Vulvovaginal chronic graft‐versus‐host disease (vv‐cGvHD) is an underrecognised complication after allogeneic haematopoietic stem cell transplantation (HSCT), with potential impact on sexual function, quality of life, and long‐term morbidity. Few prospective data are available in the literature based on systematic gynaecological assessment. Material and Methods A prospective, observational, single‐centre study was carried out to evaluate 1‐year incidence and clinical features of vv‐cGvHD in female patients undergoing HSCT among patients alive and relapse‐free at day + 100. Standardised gynaecological examinations were performed at baseline, day + 100, 6, and 12 months. Data collection included patient‐reported outcomes by use of a symptom‐focused questionnaire to assess the presence and impact of vv‐cGvHD. Results Forty‐one evaluable patients were included in the analysis and followed with scheduled gynaecological evaluations at defined intervals post‐transplant. Vv‐cGvHD was diagnosed in 12 out of 41 patients (29.3%), with six cases classified as grade 1 and six as grade 2 according to NIH criteria. The conditional cumulative incidence at 1 year was 30%. Half of the affected patients presented isolated genital involvement, without other cGvHD manifestations. Median onset was 6 months post‐transplant. Chronic GvHD in other organs was the only factor associated with vv‐cGvHD in univariate analysis ( p = 0.02). Topical treatment with corticosteroids and hyaluronic acid was administered to 75% ( n = 9) of affected patients, with no cases progressing to severe disease requiring surgical intervention. Conclusion This study highlights a considerable incidence of vv‐cGvHD among HSCT recipients, underlining the need for systematic screening and management protocols.
Palmisano et al. (Thu,) studied this question.