CONCLUSION
Appendiceal disease in hematopoietic stem cell transplant patients is
rarely reported and there is little guidance in management. Our patients
were all effectively treated for their appendiceal disease. Based on our
experience, in pre-transplant patients who present with appendiceal
disease there is a need to balance the risks and benefits of definitive
surgical resolution of the appendiceal disease. Pre-transplant patients
with severe cytopenias from chemotherapy should be considered to receive
a trial of medical therapy with plan for appendectomy after recovery but
prior to transplant. Appendicitis in pre-engraftment patients may be
confounded by alternative infectious process or mucositis. In these
patients a trial of medical therapy may be considered with subsequent
evaluation after engraftment. Post-transplant patients on
immunosuppression may receive a trial of medical therapy with plan for
appendectomy after completion of immunosuppression.