[DuckJibe]

Tests and imaging before a stem cell transplant

by DuckJibe on Mon Sep 21, 2015 5:37 pm

Hello to all,

I am contemplating a stem cell transplant and had some questions. To all who have had an autologous stem cell transplant, was a CT scan part of the pre-transplant procedure? A bone marrow biopsy? Any other tests before the transplant?

Kind Regards,
Frank

[Lev]

Re: Tests and imaging before a stem cell transplant

by Lev on Mon Sep 21, 2015 10:21 pm

Hi Frank,

Yes, a CT + MR and PET. And bone marrow biopsies. And a lot of blood and urine tests.

The bone marrow biopsy is especially important to establish your type of myeloma and the severity.

You are seeing a myeloma spacialist?

Best regards,

Lev

[3334]

Re: Tests and imaging before a stem cell transplant

by 3334 on Mon Sep 21, 2015 10:50 pm

Most transplant centers have standing orders for evaluation.

My pre-transplant evaluation orders included: CBC, comprehensive metabolic panel,
hepatic panel, LDH, magnesium, coagulation studies, type and screen, rpr, hepatitis
screening, HIV screening, CMV, West Nile virus, herpes virus screening, Epstein Barr virus,
varicella zoster IgG, chagas screen/ripa, htlv ab, routine urinalysis, beta-2 microglobulin,
SPEP, UPEP, M-spike quantification, immunofixation, free light chains, chest xray, skeletal survey, bone marrow aspirate and biopsy with cytogenetics and FISH myeloma panel, EKG, 2D echocardiogram, arterial blood gases, and pulmonary function tests.

I have IgG kappa light chain myeloma and AL amyloidosis. Because of the amyloidosis, my evaluation also included 24-hour urine tests, troponin, bnp, ultrasounds of the liver and spleen, and a bone marrow amyloidosis stain.

My autologous hematopoietic stem cell transplant is scheduled in 2 to 3 weeks. I feel healthy and confident.

Good luck!
Margo

[JPC]

Re: Tests and imaging before a stem cell transplant

by JPC on Tue Sep 22, 2015 6:27 am

Hi Frank:

Very good list from Margo. I would add one thing, they advise you to get your dental work (annual check up) done before the autologous stem cell transplant (ASCT), so you don't come down with a cavity or other potential source of infection shortly after the ASCT when you are immuno­sup­pressed, before your WBC comes back. Have the dental appointment done a month before the ASCT so that you have time if you need a follow up.

For the bone marrow biopsy (BMB), in order to evaluate the success of the ASCT, you should have one right before (after completion of induction), and at the 100 day mark. I would read those two reports very closely as it has very detailed info.

For imaging, that is a more complicated question, and I think its done differently by different doctors. You can get it done more frequently if it is established you have active bone problems (which I hope is not the case). In the absence of active bone involvement, you can get a PET-CT scan once a year, but that depends on insurance. There are also contrast CT's and targeted MRI's that are done, however, I am not sure as to which ones are appropriate in the differing scenarios. The PET-CT should have been sometime at the start of induction, and should be redone about a year after.

Good luck.

[Mister Dana]

Re: Tests and imaging before a stem cell transplant

by Mister Dana on Wed Sep 23, 2015 4:16 pm

I had skeletal X-rays, CT, PET and BMB as part of my diagnosis. Because I have nonsecretory multiple myeloma, I needed the PET and BMB again halfway through my five months of induction chemo to evaluate how it was working. Still, when I showed up at Mayo Clinic for my ASCT, they too re-did the PET and BMB.

As the other commenter said, they also run a battery of tests to make sure you are healthy enough to continue. They checked my blood, urine, chest X-ray, heart function, kidney function, and lung function. Then I went to oral surgery to ensure that I didn't have any potential infection in my jaws. You get the best exam of your life before they give the high dose chemo and transplant.