Genital GVHD in Female Children and Adolescents: A Systematic Review of Case Reports and Case Series
Maria Tsimeki,
Antonios Tsimpidakis,
Stella Roidi,
Themos Gregoriadis,
Alexandra Soldatou,
Vasiliki Kitra,
Lina Michala
Affiliations
Maria Tsimeki
First Department of Obstetrics and Gynecology, School of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
Antonios Tsimpidakis
First Department of Dermatology-Venereology, School of Medicine, Andreas Syngros Hospital, National and Kapodistrian University of Athens, 16121 Athens, Greece
Stella Roidi
First Department of Obstetrics and Gynecology, School of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
Themos Gregoriadis
First Department of Obstetrics and Gynecology, School of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
Alexandra Soldatou
Second Department of Pediatrics, School of Medicine, Children’s Hospital of Athens “P. & A. Kyriakou”, National and Kapodistrian University of Athens, 11527 Athens, Greece
Vasiliki Kitra
Stem Cell Transplant Unit, “Agia Sofia Children’s Hospital” Infectious Diseases Unit, Department of Pathophysiology, School of Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
Lina Michala
First Department of Obstetrics and Gynecology, School of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
Genital graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT) is an underdiagnosed manifestation of chronic GVHD. Few articles have been published in pediatric populations, and there are no established guidelines for the management of this condition in children. This study aims to provide a systematic literature review of the published studies and cases of genital (vulvovaginal) GVHD in girls and adolescents post HSCT, with a focus on the time of diagnosis and clinical manifestations. The authors searched for English-language articles published after 1990, which included full patient details. Thirty-two cases of female patients under 20 years of age were identified. The median time of diagnosis was 381 days (IQR: 226–730 days), and 83% of patients developed Grade 3 vulvovaginal GVHD. Based on these observations, an early pediatric gynecologic examination of these patients, soon within the first year after HSCT, could be suggested for early diagnosis, treatment initiation and prevention of long-term complications.
