title: Evaluation of the pretransplantation workup before allogeneic transplantation.
abstract: An extensive workup is generally performed before allogeneic transplantation. The extent of this workup varies substantially between centers because of a lack of guidelines. We analyzed 157 consecutive allogeneic transplant candidates to understand the significance of components of the pretransplant evaluation. Workup consisted of chest computed tomography (CT); magnetic resonance imaging of the head; dental, ears-nose-throat (ENT), ophthalmology, and gynecology evaluations; pulmonary function tests; echocardiography; cytomegalovirus PCR; urine culture; clinical evaluation; and disease staging. Results were categorized as "normal or minor finding" or "major finding" (having significant consequences such as further testing or therapy). Major findings were classified as incidental or related to history and symptoms. Components of the pretransplant workup with the highest rate of major findings were CT (22%), dental evaluation (13%), and ENT (12%, mostly symptomatic). All other components had a low rate of major findings. Although 126 transplants were performed as scheduled, 24 were delayed and 7 canceled at short notice. The main reasons for delaying or canceling transplantation were active infection and unexpected disease progression. A prospective evaluation of a more restricted, symptom-guided pretransplant evaluation appears to be warranted.
authors: Division of Hematology, University Hospital Basel, Basel, Switzerland. Electronic address: sabine.gerull@usb.ch.
authors: Sabine
authors: S
authors: Gerull
authors: Division of Hematology, University Hospital Basel, Basel, Switzerland.
authors: Michael
authors: M
authors: Medinger
authors: Division of Hematology, University Hospital Basel, Basel, Switzerland.
authors: Dominik
authors: D
authors: Heim
authors: Division of Hematology, University Hospital Basel, Basel, Switzerland.
authors: Jakob
authors: J
authors: Passweg
authors: Division of Hematology, University Hospital Basel, Basel, Switzerland.
authors: Martin
authors: M
authors: Stern
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006402:Hematologic Diseases / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000379:methods*; D055815:Young Adult
keywords: Allogeneic transplantation; Evaluation; Pretransplant; Workup