The pre-transplant evaluation, which includes a variety of tests providing complete information about the overall health of the patient, helps the transplant team to identify if there is a risk of any potential problem and also to avoid potential problems after the transplantation.
- Bone marrow biopsy is performed to assess for disease involvement and to evaluate the marrow’s function.
- Blood Tests:
* Tissue typing to evaluate the compatibility of tissue between the donor and the recipient.
* Infectious disease is screening for hepatitis, Epstein-Barr virus, HIV, Herpes Simplex virus, syphilis, etc.
* Checking organ function such as complete metabolic panel, hemoglobin solubility, pregnancy test, ABO blood type, bleeding times, CBC and platelets.
- Chest X-ray of heart and lungs for information regarding their sizes and to detect the presence of infection or lung disease.
- Pulmonary function tests (PFT) to measure the capacity and functioning of the lungs and the ability of the blood to carry oxygen.
- Computed tomography scan (CT) gives a detailed image of the body and helps the radiologist to determine the extent of the disease and other abnormalities present in the body.
- Positron emission tomography (PET) scan helps the doctors to view how the organs and tissues inside the patient’s body are actually functioning.
- Heart tests like electrocardiogram and echocardiogram are ordered since the chemotherapy, and /, or radiation therapy are likely to affect the heart.
- Other tests like skeletal survey, Pap smear, colonoscopy, mammograms or dental exams may also be carried out.
- The patient might have to undergo chemotherapy or radiation to kill off all the cancerous cells or the marrow cells before being transplanted with new stem cells. This is done in two ways depending on the age of the patient, the health and the type of disease which is being treated.
* Ablative / myeloablative treatment - This uses a high dose of chemotherapy or radiation to kill the cancer cells. In the process, the remaining healthy bone marrow cells are also killed allowing the growth of new stem cells in the bone marrow.
* Reduced intensity treatment / mini-transplant - In this method, a milder dose of chemotherapy or radiation are given to the patients prior to the transplant. This is used mainly for older people and individuals who have health problems enabling them to have a transplant.