Increased cervical dysplasia in intravenous cyclophosphamide-treated patients with SLE: a preliminary study

To determine if intravenous cyclophosphamide (IV-C) causes an excess of cer vical dysplasia and/or cancer in systemic lupus erythematosus (SLE) patient s, 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 a bsence of pertinent data. Ws found 10 cases of cervical dysplasia In the re maining 61 patients, compared to 2 in 49 non-exposed patients (P < 0.04). C omparison of the two groups revealed no difference in: mean years of diseas e 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 estro gen use. There was a significant decrease in time to dysplasia in those, gi ven IV-C, with previous dysplasia compared to those without. These preliminary data suggests that IV-C causes an increased number of abn ormal Papanicolaou (Pap) smears In SLE patients, particularly those with pr evious dysplasia.