{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:35:52Z","timestamp":1760315752881,"version":"build-2065373602"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T00:00:00Z","timestamp":1559174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Allogenic hematopoietic stem cell transplantation (allo\u2010HSCT) is a common procedure in hematological disorders and is preceded by a conditioning regimen that usually includes busulfan. The immunosuppression caused by the conditioning regimen and graft\u2010versus\u2010host disease prophylaxis is associated with human papillomavirus (HPV) persistence and, consequently, with an increased risk of cervical cancer (CC) and squamous intraepithelial lesions (SILs)\u2014the precursors of CC. A gynecological check\u2010up that includes CC screening is recommended in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All female recipients of allo\u2010HSCT undergo routine gynecological check\u2010up that includes CC screening. Cervical samples were obtained for liquid\u2010based cytology and HPV testing. Cytology smears were stained with the Papanicolaou (Pap) technique. A colposcopy evaluation was performed if any abnormal result in the screening tests was obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 15 women undergoing gynecological examination at 1\u00a0year after allo\u2010HSCT who had received a conditioning regimen that included busulfan, 4 (26.7%) showed atypical squamous cells in the Pap smear, suggesting high\u2010grade SIL. The abnormalities were identified from 136 to 271\u00a0days after allo\u2010HSCT. In all cases, HPV testing was negative, and colposcopy examination was normal. The cytological abnormalities regressed in 3 of the women after 1\u00a0year but persisted in 1 woman at day 382 after allo\u2010HSCT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment\u2010related atypia mimicking SIL is a common finding in allo\u2010HSCT recipients who have received busulfan, particularly in the first year after the procedure. However, atypical changes may persist for more than 1\u00a0year. Clinical information, HPV testing, and colposcopy examination are critical to prevent misdiagnosis and overtreatment in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22148","type":"journal-article","created":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T09:10:01Z","timestamp":1559207401000},"page":"399-406","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Atypical cytological changes mimicking SIL of the uterine cervix in allogenic hematopoietic stem cell transplantation recipients treated with busulfan"],"prefix":"10.1002","volume":"127","author":[{"given":"Adela","family":"Saco","sequence":"first","affiliation":[{"name":"Department of Pathology Hospital Clinic, University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Al\u00f2s","sequence":"additional","affiliation":[{"name":"Department of Pathology Hospital Clinic, University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roser","family":"Esteve","sequence":"additional","affiliation":[{"name":"Department of Pathology Hospital Clinic, University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Su\u00e1rez\u2010Lled\u00f3","sequence":"additional","affiliation":[{"name":"Long\u2010Term Follow\u2010Up Unit and Hematopoietic Stem Cell Transplantation Unit, Hematology Department, Institute of Hematology and Oncology August Pi i Sunyer Institute for Biomedical Investigations, University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Long\u2010Term Follow\u2010Up Unit and Hematopoietic Stem Cell Transplantation Unit, Hematology Department, Institute of Hematology and Oncology August Pi i Sunyer Institute for Biomedical Investigations, University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco M.","family":"Perez","sequence":"additional","affiliation":[{"name":"Department of Pathology Hospital Clinic, University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naiara","family":"Vega","sequence":"additional","affiliation":[{"name":"Department of Pathology Hospital Clinic, University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Mart\u00ed","sequence":"additional","affiliation":[{"name":"Institute Clinic of Gynecology, Obstetrics, and Neonatology Hospital Clinic, August Pi i Sunyer Institute for Biomedical Investigations, University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aureli","family":"Torne","sequence":"additional","affiliation":[{"name":"Institute Clinic of Gynecology, Obstetrics, and Neonatology Hospital Clinic, August Pi i Sunyer Institute for Biomedical Investigations, University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaume","family":"Ordi","sequence":"additional","affiliation":[{"name":"Department of Pathology Hospital Clinic, University of Barcelona Barcelona Spain"},{"name":"ISGlobal, Hospital Clinic University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2178-2403","authenticated-orcid":false,"given":"Marta","family":"del Pino","sequence":"additional","affiliation":[{"name":"Long\u2010Term Follow\u2010Up Unit and Hematopoietic Stem Cell Transplantation Unit, Hematology Department, Institute of Hematology and Oncology August Pi i Sunyer Institute for Biomedical Investigations, University of Barcelona Barcelona Spain"},{"name":"Institute Clinic of Gynecology, Obstetrics, and Neonatology Hospital Clinic, August Pi i Sunyer Institute for Biomedical Investigations, University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,5,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2013.02.005"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-10-263095"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61416-0"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2015.63"},{"key":"e_1_2_8_6_1","first-page":"466","article-title":"Cytologic dysplasia related to busulfan (Myleran) therapy. 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