About the Investigator:

Dr. Lev-Sagie is a specialist in Obstetrics and Gynecology and an expert in vulvovaginal disorders at Hadassah Medical Center. She received her MD degree and carried out a Residency in Ob/Gyn at Hadassah Medical School of the Hebrew University of Jerusalem, and was a Visiting Fellow at Weill Medical College of Cornell University, in New York. Upon returning to Israel, she established a clinic dedicated to diagnosing and treating women who underwent bone marrow transplantation and then experienced a complication called “genital graft versus host disease.” She studies the long-term consequences of this disease, and has recently designed, conducted, and published the first study of whether disease can be alleviated by transferring vaginal bacteria from healthy women to women with vaginal disease, in a process known as “vaginal microbiome transplantation.” This proposal is built on preliminary results that support the utility of this unique treatment for vaginal disorders.

About the Research:

Bone marrow transplantation involves transferring cells from a healthy person to a cancer patient, after high-intensity chemotherapy or radiation is given to destroy cancer cells. When successful, the donor stem cells replace the original cells in the bone marrow, providing a long-term cure of the patient’s cancer. However, transplant-related complications often arise. One of these is graft-versus-host disease, which occurs when donor immune cells identify the recipient’s cells as foreign and attack them. Approximately half of the women undergoing bone marrow transplantation will experience vaginal graft-versus-host disease. This may cause irreversible anatomical changes, including complete vaginal obliteration, and severely impact patients’ quality of life and sexual function. This complication is currently unpredictable and non-preventable, requires frequent gynecological examinations and prolonged follow-up, and causes extreme anxiety for the patients.Improving and maintaining cancer patients’ quality of life in the aftercare period is very important. This study aims to evaluate the association between the vaginal bacteria (the “microbiome”) and the progress of vaginal graft-versus-host disease. Given the prevalence of vaginal graft-versus-host disease among transplanted women and its devastating consequences, finding such an association may lead to better prediction and understanding of vaginal graft-versus-host disease, and development of interventions for treatment and prevention.