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Imaging the Complications of Bone Marrow Transplantation in Children¹

¹ From the Department of Diagnostic Imaging (D.S.L., O.M.N., G.C., S.I.B.) and the Department of Pediatrics, Division of Hematology/Oncology (J.J.D.), Hospital for Sick Children and University of Toronto, 555 University Ave, Toronto, Ontario, Canada M5G 1X8. Recipient of a Certificate of Merit award for an education exhibit at the 2005 RSNA Annual Meeting. Received May 3, 2006; revision requested June 5 and received July 19; accepted July 21. J.J.D. is a medical consultant for Insception Biosciences, Toronto, Ontario, Canada; all remaining authors have no financial relationships to disclose. Address correspondence to O.M.N. (e-mail: oscar.navarro{at}sickkids.ca).

Bone marrow transplantation is frequently performed to restore hematologic and immunologic competence after chemotherapy and radiation therapy for a range of childhood malignancies, as well as to treat various congenital conditions in which hematologic and immunologic functions are depressed or absent. Potentially devastating complications may occur during the pre-engraftment period after bone marrow transplantation, when marrow aplasia may supervene for several weeks until engraftment occurs, as well as during the postengraftment period (the 3 months after engraftment) and in subsequent months and years. Complications of bone marrow transplantation may be classified either according to the time interval between transplantation and the occurrence of the complication or according to the organ system affected. The range of complications that may affect the central nervous system and the rest of the body may be detected with ultrasonography, computed tomography, and magnetic resonance imaging. Neurologic, paranasal sinus, pulmonary, and abdominopelvic complications all may be seen after bone marrow transplantation. Graft-versus-host disease and lymphoproliferative disorders also may occur. The increasing use of bone marrow transplantation mandates that the radiologist be familiar with the full range of potential complications and their imaging appearances.

© RSNA, 2007

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