Utility of Computed Tomography Surveillance of Asymptomatic Infection in Children and Young Adults Before Allogeneic Hematopoietic Stem Cell Transplant

Asymptomatic infection poses a significant risk for children undergoing hematopoietic stem cell transplantation (HSCT). Pre-transplant surveillance computed tomography (CT) is commonly used to identify occult infection, though its diagnostic yield remains uncertain. We retrospectively reviewed pre-HSCT CT examinations from 635 first-time allogeneic transplant recipients to assess the frequency of occult pulmonary and abdominal infection. Potentially infectious findings were reported in 22% (110/494) of chest CTs but were uncommon in abdomen/pelvis CTs (2%; 7/449). These findings suggest that chest-only surveillance imaging may be more efficient and could reduce unnecessary radiation and contrast exposure in pediatric HSCT candidates.