[Transfusion management and immuno-hematological follow-up after allogeneic hematopoietic cell transplantation: Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)]. / Prise en charge transfusionnelle et suivi immunohématologique après allogreffe de cellules souches hématopoïétiques : recommandations de la Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC).

The French High Authority of Health (HAS) and National Drug Safety (ANSM) agencies recommendations issued in 2014, the French General Direction of Health (DGS) instruction published in November 2021, the French National Blood Bank (EFS) guidelines and the data available in the literature globally define "good transfusion practices" but provide little information about the immuno-hematological and transfusion management of patients who have received an allogeneic hematopoietic stem transplantation (allo-HCT). The aim of this workshop was to harmonize these practices in situations for which there are currently no recommendations. In order to anticipate possible transfusion issues after allo-HCT, we recommend performing, before the transplantation, an extended red blood cell phenotyping of the donor and a detection of HLA alloimmunization in the recipient. We recommend to systematically perform for minor ABO mismatches: a direct antiglobulin test between D8 and D20, and for major ABO mismatches; a titration of anti-A/anti-B antibodies and an erythrocyte chimerism at D100. At one-year post-transplant, we recommend carrying out an erythrocyte chimerism to allow, if necessary, the update of transfusion counselling (RH phenotype, irradiation of packed red blood cells).

[Haematopoietic stem cell donation from minor donor: Respecting laws, assessing fitness, delivering information and good care (SFGM-TC)]. / Don de cellules souches hématopoïétiques à partir d'un donneur mineur : cadre réglementaire, information, évaluation de l'aptitude au don et parcours (SFGM-TC).

Haematopoietic stem cell collection from paediatric donors is a common and life-saving practice, as evidenced by the fact that there is a growing annual number of cases of transplants from minor donors among SFGM-TC centers over the last decade. Still, medical use of human tissue from a healthy and underage donor requires proper regulations and medical management. The guidelines below aim at underlining the importance of pondering the legal, medical and ethical aspects of using stem cells from healthy paediatric donors and stress out the importance of obtaining informed consent at the time of assessing HLA compatibility. Combined medical and psychological assessments are required before the donation, as well as one month later and one year later to ensure of the child's physical and mental wellbeing. Bone marrow harvest under general anaesthetics remains the preferred method of collection for children. Peripheral blood stem cell collection should only be considered for children who will not require a central venous access for collection. We aim at offering guidelines centered on the healthy child donating stem cells and his/her wellbeing, and these should be regularly reviewed as medical practices evolve.

[Drug-drug interactions and physicochemical incompatibilities during acute phase after allo-SCT: Guidelines from the SFGM-TC]. / Interactions médicamenteuses et incompatibilités physico-chimiques en phase aiguë post-allogreffe : quelle influence des médicaments de support ? Recommandations de la SFGM-TC.

Since patients require multiple intravenous drugs, drug incompatibilities and drug interactions are frequent during the acute phase following hematopoietic cell transplantation. The risk of drug-drug interactions is increased in patients with several comorbidities. The goal of this workshop was to learn how to mitigate the risks of drug incompatibilities and interactions when their usage is therapeutically warranted. Our focus was on proton pump inhibitors and antiemetic drugs as they are routinely used in hematopoietic transplants and frequently lead to incompatibilities and interactions with other drugs such as immunosuppressives and antimicrobials. Routine procedures in transplantation such as the choice of vascular access devices, the setting of infusion lines, the scheduling of administration of drugs and their dilution volumes can be effective armaments to mitigate the risks of drug incompatibilities and interactions. In addition, a multidisciplinary concertation between clinicians, pharmacists and nurses is a key point in the success of patient's care.