Abnormal cervical cytology after allogeneic bone marrow transplantation

Area of Science:

• Gynecologic Oncology
• Hematology
• Cytopathology

Background:

• Allogeneic bone marrow transplantation (BMT) is a critical treatment for high-risk hematologic malignancies.
• Routine gynecologic follow-up for women post-BMT includes Papanicolaou (Pap) smears.

Purpose of the Study:

• To evaluate Papanicolaou (Pap) smear findings in women following allogeneic bone marrow transplantation (BMT).
• To correlate smear morphology with BMT-related medical treatments, particularly conditioning regimens.

Main Methods:

• Analysis of 117 Pap smears from 54 women who underwent allogeneic BMT.
• Correlation of cytologic findings with specific BMT conditioning therapies and medications.

Main Results:

• Abnormal Pap smears were observed in 24.1% of women post-BMT.
• Atypical squamous cells of unknown significance (ASC-US), low-grade squamous intraepithelial lesions (LSIL), and ASC-H were identified.
• Nine women, including three with ASC-H, received busulfan-based conditioning; no other drug associations were found.

Conclusions:

• Pap smears post-BMT demonstrate a high incidence of dysplastic lesions.
• Busulfan-containing conditioning therapy is frequently associated with therapy-related cytologic atypia.
• Careful evaluation and knowledge of patient history are crucial to avoid unnecessary colposcopies and biopsies.