title: Abnormal cervical cytology after allogeneic bone marrow transplantation.
abstract: OBJECTIVE
  Allogeneic bone marrow transplantation (BMT) is a procedure mostly used for high-risk hematologic malignances. In women, follow-up protocols after BMT include gynecologic checkups with Papanicolaou (Pap) smears.
  
  
  METHODS
  We evaluated 117 Pap smears in 54 women who underwent allogeneic BMT and correlated the smear morphology with the BMT-related medical treatment.
  
  
  RESULTS
  Abnormal Pap smears after BMT were found in 13 (24.1%) women. Four (7.4%) women had at least one smear with atypical squamous cells of unknown significance, six (11.1%) had a low-grade squamous intraepithelial lesion, and three (5.6%) had atypical squamous cells/high-grade lesion cannot be excluded (ASC-H). The three patients with ASC-H showed high-grade atypia mimicking cancer but had a negative follow-up. Nine women, including the three with ASC-H, had undergone a conditioning therapy for BMT that included busulfan. No association between other drugs and therapy-related atypia was found.
  
  
  CONCLUSIONS
  Pap smears after BMT show a high incidence of dysplastic lesions. Moreover, conditioning including busulfan is often associated with therapy-related cytologic atypia, which may lead to unnecessary colposcopies and biopsies. Knowledge of the patient's history and a careful evaluation of the smears are mandatory in these cases.
authors.affiliation: From the Department of Pathology, Central Hospital Bolzano, Bolzano, Italy; ginegri@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Negri
authors.affiliation: From the Department of Pathology, Central Hospital Bolzano, Bolzano, Italy;
authors.forename: Martina
authors.initials: M
authors.lastname: Herz
authors.affiliation: Hematology and BMT Department, Central Hospital Bolzano, Bolzano, Italy;
authors.forename: Sara
authors.initials: S
authors.lastname: Deola
authors.affiliation: Hematology and BMT Department, Central Hospital Bolzano, Bolzano, Italy;
authors.forename: Andrea
authors.initials: A
authors.lastname: Piccin
authors.affiliation: Hematology and BMT Department, Central Hospital Bolzano, Bolzano, Italy;
authors.forename: Marco
authors.initials: M
authors.lastname: Casini
authors.affiliation: Consultant Gynecologist, Bolzano, Italy;
authors.forename: Bianca
authors.initials: B
authors.lastname: Babich
authors.affiliation: From the Department of Pathology, Central Hospital Bolzano, Bolzano, Italy;
authors.forename: Martina
authors.initials: M
authors.lastname: Tauber
authors.affiliation: Department of Gynecology and Obstetrics, Central Hospital Bolzano, Bolzano, Italy;
authors.forename: Sergio
authors.initials: S
authors.lastname: Messini
authors.affiliation: Department of Pathology I and II, Spedali Civili-University of Brescia, Brescia, Italy; and.
authors.forename: Maria Raffaella
authors.initials: MR
authors.lastname: Marucci
authors.affiliation: Explora Research and Statistical Analysis, Padova, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Vittadello
mesh_terms: D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D065006:Papanicolaou Test / Q000379:methods; D011247:Pregnancy; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000628:therapy; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy; D014626:Vaginal Smears / Q000379:methods; D055815:Young Adult
keywords: Atypia; Bone marrow transplantation; Busulfan; Cervical cytology; Pap smear