title: Increased cervical dysplasia in intravenous cyclophosphamide-treated patients with SLE: a preliminary study.
abstract: To determine if intravenous cyclophosphamide (IV-C) causes an excess of cervical dysplasia and/or cancer in systemic lupus erythematosus (SLE) patients, a retrospective review was conducted. Patients with SLE who received IV-C between 1988-98 (study group) were compared with a group of SLE patients who had not received IV-C (control group). Of the 79 IV-C-treated SLE patients identified, we excluded 18 because of absence of pertinent data. We found 10 cases of cervical dysplasia in the remaining 61 patients, compared to 2 in 49 non-exposed patients (P<0.04). Comparison of the two groups revealed no difference in: mean years of disease duration, months of follow-up and age. The non-exposed patients were more likely to be on estrogen and hydroxychloroquine but less often on steroids and azathioprine. The study group with and without dysplasia were assessed; we found no difference in the mean, or total IV-C dose, smoking and estrogen use. There was a significant decrease in time to dysplasia in those, given IV-C, with previous dysplasia compared to those without. These preliminary data suggests that IV-C causes an increased number of abnormal Papanicolaou (Pap) smears in SLE patients, particularly those with previous dysplasia.
authors.affiliation: Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, USA.
authors.forename: H
authors.initials: H
authors.lastname: Bateman
authors.forename: Y
authors.initials: Y
authors.lastname: Yazici
authors.forename: L
authors.initials: L
authors.lastname: Leff
authors.forename: M
authors.initials: M
authors.lastname: Peterson
authors.forename: S A
authors.initials: SA
authors.lastname: Paget
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001208:Asia / Q000208:ethnology; D044383:Black People; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino; D006801:Humans; D007262:Infusions, Intravenous; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D009518:New York; D012189:Retrospective Studies; D016019:Survival Analysis; D002578:Uterine Cervical Dysplasia / Q000139:chemically induced / Q000453:epidemiology* / Q000401:mortality; D044465:White People; D001741:Black or African American
chemical_list: D018501:Antirheumatic Agents; D003520:Cyclophosphamide