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Related Concept Videos

Regulation of Hematopoietic Stem Cells01:01

Regulation of Hematopoietic Stem Cells

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All blood and immune cells are produced from the multipotent hematopoietic stem cells (HSCs) by the process of hematopoiesis. However, they all have a limited life span. In addition, many are depleted in immune surveillance or combatting an injury or infection. This makes blood one of the most regenerative tissues. Hematopoiesis helps replenish these blood and immune cells, restoring the body's normal functioning. However, overproduction of blood and immune cells can make them cancerous or...
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Human Papillomavirus Infection and Cytological Atypia in Female Allogeneic Hematopoietic Stem Cell Transplantation

Adela Saco1,2, Sara Carbonell2,3, Natalia Rakislova1,4

  • 1Department of Pathology, Hospital Clínic, University of Barcelona, Barcelona, Spain.

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Female transplant recipients require ongoing gynecological screening due to significant human papillomavirus (HPV) infection rates and potential for developing precancerous lesions. HPV testing is crucial for accurate risk assessment and distinguishing true lesions from treatment-related changes.

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Area of Science:

  • Oncology
  • Gynecology
  • Transplantation Medicine

Background:

  • Female allogeneic hematopoietic stem cell transplant (HSCT) recipients face elevated risks of human papillomavirus (HPV)-associated lesions and precancer.
  • A cervical cancer screening program was implemented to monitor these high-risk individuals.

Purpose of the Study:

  • To evaluate the effectiveness of a standardized gynecological screening protocol in female HSCT recipients.
  • To determine the prevalence of HPV infection and related lesions in this population.

Main Methods:

  • A cohort of 70 female HSCT recipients underwent standardized gynecological evaluations between 2010 and 2022.
  • Evaluations included human papillomavirus (HPV) testing, Papanicolaou smears, and thorough gynecological examinations.

Main Results:

  • The cumulative prevalence of HPV infection was 21.4%, with 14.3% testing positive initially and an additional 7.1% during follow-up.
  • 18.5% of women presented with cytohistological lesions (3 high-grade, 10 low-grade).
  • 41.4% showed HPV-negative reactive atypical changes mimicking HPV lesions, which resolved spontaneously.

Conclusions:

  • Long-term gynecological evaluation is essential for HSCT recipients due to the risk of later HPV positivity.
  • Reactive benign changes mimicking HPV lesions are common post-treatment and require careful differentiation.
  • HPV testing is vital for identifying at-risk patients and excluding cytological mimics in HSCT recipients.