{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:22Z","timestamp":1787013862343,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T00:00:00Z","timestamp":1640649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Genital chronic graft\u2010vs\u2010host disease (cGvHD) is a common late effect after allogeneic stem cell transplantation. In a previous cross\u2010sectional study, prevalence, signs and symptoms of genital and extra\u2010genital cGvHD were accounted for in a cohort of 42 women. Classifications of cGvHD were performed as per the National Institutes of Health (NIH) 2005 criteria. In this follow\u2010up study on surviving women, the aim was to assess genital and extra\u2010genital cGvHD status after long period of time. Our hypothesis was that signs and symptoms of cGvHD alleviate over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>\n                      All surviving women (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a038) were re\u2010examined by an ophthalmologist, a gynecologist and a hematologist. Signs and symptoms were classified according to the NIH 2014 criteria. Clinical scorings of affected organs were combined for estimating global score of cGvHD. To make possible comparisons between the two studies, data from the original study were re\u2010classified as per the NIH 2014 criteria, and the four dead women were excluded. The same questionnaires were completed. Cervical smear, human papilloma virus test and vulvar photo\u2010documentation were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median time after original study was 8.4 (5.8\u201312) years and after transplant 14.5 (10\u201319.3) years. The prevalence of genital cGvHD was similar in the original (50%) and follow\u2010up (58%) studies (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.646) as well as extra\u2010genital cGvHD. Systemic corticosteroid treatment of cGvHD was ongoing in 34% and 29%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.805). Ocular cGvHD was found in 24 of 37 examined women (65%) in the follow\u2010up study. Genital cGvHD had disappeared in three women and developed in two women 5\u201312 and 9\u201317\u00a0years, respectively, after transplantation. The severity of global cGvHD changed over time in 14 women, but was the same on group level (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.345). Atrophic mucous membranes as in estrogen deficiency were seen in 66%. Three women had human papilloma virus genotypes associated with the risk of developing cervical cancer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Chronic GvHD did not alleviate over time. Allotransplanted women require early and continuous life\u2010long contact with a gynecologist and an ophthalmologist for the detection of cGvHD. Specific attention should be given to the need for local estrogen and the risk of genital epithelial malignancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14308","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T06:20:04Z","timestamp":1640672404000},"page":"364-373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Late follow\u2010up of genital and ophthalmologic chronic graft\u2010vs\u2010host disease in females after allogeneic stem cell transplantation"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7707-8602","authenticated-orcid":false,"given":"Eva","family":"Smith Knutsson","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology NU Hospital Group  Trollh\u00e4ttan Sweden"},{"name":"Sahlgrenska Academy at Gothenburg University  Gothenburg 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