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DOI: 10.1148/radiol.2482070988
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(Radiology 2008;248:348-365.)
© RSNA, 2008

Reviews

Pediatric Hematopoietic Stem Cell Transplantation and the Role of Imaging1

Caroline L. Hollingsworth, MD, MPH, Donald P. Frush, MD, Joanne Kurtzburg, MD, and Vinod K. Prasad, MD, MRCP

1 From the Department of Radiology, Division of Pediatric Radiology (C.L.H., D.P.F.) and Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation (J.K., V.K.P.), Duke University Medical Center, Box 3808, 1905 McGovern-Davison Children's Health Center, Durham, NC 27710. Received June 8, 2007; revision requested August 13; revision received September 11; accepted October 12; final review and update by C.L.H. March 4, 2008. Address correspondence to C.L.H. (e-mail: holli016{at}mc.duke.edu).

The use of hematopoietic stem cell transplantation (HSCT) in the treatment of children afflicted with many potentially fatal malignant and nonmalignant diseases is well recognized. Although outcomes continue to improve and the utility of HSCT is increasing, HSCT remains a complicated process necessitating support from many medical disciplines, including radiology. Importantly, children who undergo HSCT are at risk for the development of specific complications that are linked to the timeline of transplantation, as well as to the relationship between the underlying diagnoses, severe immune deficiency, cytoreductive regimen, and graft-versus-host reactions. An understanding of the complex interplay of the immune status, therapeutic regimen, and disease allows increased diagnostic accuracy. Successful treatment of these high-risk children requires that radiologists who are involved with their care be familiar with broad concepts, as well as with specific problems that frequently occur following HSCT. In this article, the clinical aspects of pediatric HSCT are summarized, including common complications, and imaging features of these complications are described.

© RSNA, 2008




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