Role of Imaging and Interventions in Bone Marrow Transplantation

Hematopoietic stem cell transplantation (HSCT) is a vital procedure used to restore bone marrow and immune function in patients with severe hematologic and immunologic disorders. While potentially curative, the process involves intensive conditioning and posttransplant recovery phases that expose patients to potentially life-threatening complications. This article outlines the spectrum of HSCT complications and emphasizes the crucial role of imaging in patient management. Immunosuppression renders patients highly susceptible to fungal, viral, and bacterial infections affecting the pulmonary, hepatic, gastrointestinal, genitourinary, and central nervous systems. Major noninfectious complications include diffuse alveolar hemorrhage, hepatic veno-occlusive disease/sinusoidal obstruction syndrome, posttransplant lymphoproliferative disorder, and graft versus host disease. A structured pretreatment checklist is essential for assessing baseline organ function, screening for latent infections, and confirming disease remission. In the posttransplant setting, a systematic approach that correlates specific radiological patterns with the temporal onset of symptoms is crucial for narrowing the differential diagnosis. Interventional radiology provides vital services such as central venous catheter placement and image-guided biopsies. Multidisciplinary approach with appropriate radiological expertise ensures the timely diagnosis of complications, guides targeted therapies, and optimizes the long-term survival of HSCT patients.