Purpose or Case Report: Sickle Cell Disease (SCD) affects approximately 100,000 individuals in the US. Despite medical advances, morbidity is high and their lifespan remains shortened. Hematopoietic stem cell transplantation (HSCT) is the only curative treatment to date and as outcomes improve its use has increased. Complications of HSCT are frequent and some literature suggests there is a higher incidence in the SCD population. In addition, preexisting vasculopathy in this population may contribute to an increased incidence of post-transplant CNS toxicity. We present the imaging findings of HCST complications in children with SCD.
Methods & Materials: Fourteen pediatric patients with SCD underwent HSCT at our institution from 2013 to 2016. A retrospective review of the diagnostic imaging demonstrated post-transplant complications in 9 patients. The radiographic, CT, US and MRI findings of post-transplant complications are presented. In addition, a brief literature review was performed to compare and supplement our findings.
Results: Post HCST complications included neurologic (intracranial hemorrhage, stroke, posterior reversible encephalopathy syndrome (PRES) and postictal changes), infectious (pneumonia, cystitis, colitis, nephritis), graft versus host disease, hepatic veno-occlusive disease and drug related complications (pneumatosis coli, cartilage delamination).
Conclusions: As utilization of HSCT in SCD patients increases, a proportionate increase in post-transplant complications is to be expected. Awareness of the potential complications and their imaging appearance is crucial for timely diagnosis and management.