Hematologist
CION Cancer Clinics
Transplant workup: every test before admission | CION Cancer Clinics
Before a bone marrow transplant you will have tests in six areas: where the disease stands, donor matching, heart and lungs, kidney and liver function, an infection screen, and teeth and fertility. They show whether the transplant is still the right step and whether your body is ready for it. Here is what each test checks and what to bring. At CION Cancer Clinics, our haematology team assesses whether a transplant or CAR-T fits your situation and coordinates care with qualified centres.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- What tests are done before a bone marrow transplant?
- Which tests fall into which group?
- What do the words on the reports mean?
- In what order do the tests usually happen?
- What should you bring to the workup?
- What do families often misunderstand about the workup?
- What happens if a test result is not normal?
- Common questions about transplant workup tests
The short answer
What tests are done before a bone marrow transplant?
Before admission you will have tests of the disease, your heart, lungs, kidneys and liver, a screen for infections, a dental check and tissue typing to match a donor. Together they answer two questions: is the transplant still the right step, and is your body ready for it?
Why so many tests
The high-dose treatment given before the new stem cells puts strain on every organ. The team needs to know how well each one is working before they start, so they can pick the right intensity of treatment and spot problems that must be fixed first. A hidden infection or a weak heart is far easier to deal with before admission than during it.
Who orders them
The transplant centre sets the final list. Your treating haematologist often starts some of them earlier, so the workup does not hold up the admission date. Lists differ between centres and between an autologous transplant, which uses your own cells, and an allogeneic one, which uses a donor's cells.
This page lists the tests most centres ask for. It is not your centre's checklist. Ask the transplant coordinator for that in writing.The checklist
Which tests fall into which group?
Most workups cover the same six areas. The exact tests in each depend on your disease and your centre.
Where the disease stands
A fresh bone marrow test for leukaemia or myeloma. A PET-CT scan for lymphoma. These confirm the disease is well controlled before the transplant.
Donor matching
HLA typing of you and possible donors, usually brothers, sisters, parents or children. The blood group of both is also checked.
Heart and lungs
How strongly the heart pumps and how well the lungs move oxygen.
Usually includes
- ECG and echocardiogram
- Lung function test
- Chest X-ray or CT
Kidneys, liver and blood
Blood tests for kidney and liver function, blood counts, clotting, sugar and thyroid. Some centres also check iron levels.
Infection screen
Blood tests for HIV, hepatitis B and C, CMV and other viruses that can wake up when immunity is low. Many centres also screen for TB.
Teeth, fertility and mind
A dental check, a pregnancy test where relevant, a talk about storing sperm or eggs, and a meeting with a counsellor or social worker.
Not sure whether this applies to you?
Ask an oncologistOn your workup report
What do the words on the reports mean?
- HLA typing
- A blood or cheek-swab test that reads the markers your immune system uses to tell self from not-self. Donor and patient markers are compared.
- Ejection fraction
- From the echocardiogram. How much blood the heart pushes out with each beat. Lower values mean a weaker pump.
- DLCO
- From the lung function test. How well oxygen passes from the lungs into the blood.
- CMV status
- Whether you have met cytomegalovirus before. Positive is common and simply means it needs watching after the transplant.
- MRD
- Measurable residual disease. A very sensitive test for cancer cells left in the marrow after treatment.
- HCT-CI score
- A score that adds up your other health problems to estimate transplant risk.
The usual order
In what order do the tests usually happen?
-
Tissue typing starts early
HLA typing for you and your family is often sent as soon as a transplant is first discussed. Finding a donor can take the longest, so it should not wait for anything else.
-
Disease reassessment
After the planned courses of chemotherapy, the bone marrow test or scan shows whether the disease is controlled enough to go ahead.
-
Organ and infection tests
Heart, lung, kidney, liver and infection tests are usually done in the few weeks before admission, so the results are recent.
-
Dental and other clearances
Any tooth that needs removing or filling is dealt with early, so the gum has time to heal before counts fall.
-
The pre-admission meeting
The team goes through every result with you, explains the plan and takes written consent. A central line, a thin tube into a large vein, is often placed around this time.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Before the first visit
What should you bring to the workup?
- Your original diagnosis report and bone marrow reports
- Genetic and flow cytometry reports, if you have them
- A dated list of every chemotherapy course you have had
- CDs or reports of all previous scans
- A list of current medicines, written in generic names
- Scheme cards, insurance papers and ID for patient and donor
Commonly believed
What do families often misunderstand about the workup?
"We already did these tests at diagnosis, so they are not needed again."
Chemotherapy changes the heart, lungs, kidneys and the disease itself. The team needs recent results, not the ones from months ago.
"One abnormal result means the transplant is cancelled."
Rarely. Most abnormal results lead to a treatment, a repeat test or a gentler plan. Ask what the result changes before assuming the worst.
"A positive infection test means he cannot have a transplant."
Not usually. Hepatitis B, CMV or a past TB infection can often be managed with preventive medicines during the transplant. The team needs to know about it, which is why the test is done.
"The donor only needs a blood test."
A donor has a full health check of their own, to make sure donating is safe for them and that nothing passes to you through their cells.
After the results
What happens if a test result is not normal?
Most of the time the plan adjusts rather than stops. The team may treat the problem, repeat the test, choose gentler conditioning treatment or move the admission date.
When the transplant may be delayed
An active infection, a dental problem that needs extraction, or disease that has not been controlled well enough are the usual reasons for a delay. Each is fixable in many people. Ask how long the delay is expected to be and what happens to your disease meanwhile.
When the plan may change
A weaker heart or lungs, or several other illnesses together, can push the team towards a lower-intensity transplant, or away from a transplant altogether. That is not the team giving up. It means the risk of the transplant itself has become larger than its likely benefit.
How CION helps
CION's haematology team can review your reports, present your case at a tumour board and help you understand what each result means. CION does not perform transplants, HLA typing or the transplant workup itself. It coordinates with qualified centres and tells you what to ask there.
Questions we are asked
Common questions about transplant workup tests
How long does the transplant workup take?
It varies. The organ and infection tests can be finished in a short period if appointments line up. Finding a matched donor is usually the slowest part, especially if no brother or sister matches. Ask the transplant coordinator for a realistic timeline for your own case.
Are the workup tests covered by Aarogyasri or insurance?
Some schemes and insurers cover the workup as part of the transplant package, and some do not. Check with Aarogyasri, PM-JAY, CGHS, ECHS, EHS or your insurer before the tests start, and ask the centre for a written estimate. Scheme rules change, so confirm the current ones.
Can the tests be done in our home town?
Some routine blood tests and an ECG often can, if the transplant centre accepts the laboratory. HLA typing, the bone marrow test and specialised scans are usually done where the centre tells you. Ask before booking anything locally, so you do not pay twice.
Why do they need to check my teeth?
After the high-dose treatment, your white cell count falls very low. A decayed tooth or infected gum can then become a serious infection in the blood. Treating it before admission is much safer. The dental visit is a standard part of the workup.
Does the donor also need tests?
Yes. A donor has HLA typing, blood group, infection screening and a general health check. The aim is to make sure donating is safe for the donor and that no infection passes to the patient. The donor's doctor looks after the donor's interests separately.
Should I stop any medicine before the tests?
Do not stop or change any medicine on your own. Give the team a full list, including herbal and Ayurvedic products. They will tell you if anything needs to change before a particular test or before admission.
What if the bone marrow test shows the disease is back?
The transplant is usually postponed while more treatment brings the disease back under control. Sometimes the plan changes more. This is hard news, but finding it before admission is far better than finding it after. Ask what the next treatment is and when the test will be repeated.
Can CION explain our workup reports?
Yes. Share the reports with CION's haematology team. They will explain what each result means, whether anything needs attention before admission, and what to ask the transplant centre. CION does not perform transplants or the transplant workup itself.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Accreditation and empanelment
- NABH
- NABL
- ISO 9001:2015
- ArogyaSri empanelled
- CGHS accepted
- ECHS accepted
- EHS accepted
- Major cashless insurers
Paying for it
Insurance, schemes and payment
What you actually pay usually differs a great deal from the sticker figure.
AarogyasriEmpanelled. Bring the card and a referral where you have one.
CGHS / ECHS / EHSAccepted at CION centres for eligible treatment.
Cashless insuranceMost major insurers are empanelled. Pre-authorisation is handled by our desk.
Self-payItemised estimate given before treatment starts. No EMI scheme exists.
Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. A haematology consultation can be booked at any of these centres through one helpline, and your team will tell you where each test or treatment takes place.
Warangal
Vizag
Sources
- National Cancer Institute — Stem Cell Transplants in Cancer Treatment
- NHS — Stem cell and bone marrow transplants
- Cancer Research UK — Bone marrow and stem cell transplants
- Leukemia & Lymphoma Society — Stem Cell Transplantation
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Dental, Cardiac and Infection Clearance Before TransplantWhat clearance means and why it can delay admissionFitness Assessment and Comorbidity Scoring Before TransplantHow the workup results turn into a risk scoreWho Is Eligible for a Stem Cell TransplantWhether a transplant is on the table at allDeciding on a TransplantThe full guide to the transplant decision
Talk to us
Holding a pile of workup reports?
Share them with CION's haematology team. They will explain what each result means and what to ask your transplant centre.