Gynecologic Manifestations of Leukemia in Reproductive-Age Women: Ultrasound, Cytology, and Microbiota Findings.

OBJECTIVE

To evaluate the gynecologic and reproductive changes in women of reproductive age diagnosed with leukemia, with an emphasis on menstrual disturbances, vaginal microbiota alterations, and cytological abnormalities.

METHODS

A cross-sectional observational study was conducted involving 100 female patients aged 16 - 46 years with confirmed diagnoses of acute or chronic leukemia. Clinical and gynecological examinations were performed, including cytological assessment (Pap smear), vaginal microbiological analysis, and pelvic ultrasound. Statistical analysis was performed using descriptive methods and Student t-test.

RESULTS

Hyperpolymenorrhea was observed in 62% of participants, while 21% reported secondary amenorrhea. Vaginal microbiological analysis revealed Grade III-IV dysbiosis in 77.7% of patients, with dominant growth of Candida spp., Staphylococcus aureus, and E. coli. Cytological abnormalities were detected in 50% of cases, including ASCUS (40%) and LSIL (5%). In 28% of cases, leukemic blast cells were identified in cervical smears. Ultrasound findings included enlarged ovaries and uteri in 35% of patients, with evidence of solid infiltrative changes in the external genitalia and mammary glands in isolated cases.

CONCLUSION

Leukemia in women of reproductive age is frequently associated with menstrual disorders, significant disturbances in vaginal microbiota, and cytological abnormalities, including evidence of leukemic infiltration. Early gynecological screening in such patients is essential to ensure the timely management of reproductive health complications.