Abnormal cervical cytology after allogeneic bone marrow transplantation

Giovanni Negri, Martina Herz, Sara Deola, Andrea Piccin, Marco Casini, Bianca Babich, Martina Tauber, Sergio Messini, Maria Raffaella Marucci, Fabio Vittadello

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4 Citations (Scopus)


Objectives: 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.

Original languageEnglish
Pages (from-to)222-226
Number of pages5
JournalAmerican Journal of Clinical Pathology
Issue number2
Publication statusPublished - 1 Jan 2014
Externally publishedYes



  • Atypia
  • Bone marrow transplantation
  • Busulfan
  • Cervical cytology
  • Pap smear

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Negri, G., Herz, M., Deola, S., Piccin, A., Casini, M., Babich, B., Tauber, M., Messini, S., Marucci, M. R., & Vittadello, F. (2014). Abnormal cervical cytology after allogeneic bone marrow transplantation. American Journal of Clinical Pathology, 142(2), 222-226. https://doi.org/10.1309/AJCP4SKAUS9TOTJX