[Post-transplant neurological complications: Guidelines from the francophone Society of bone marrow transplantation and cellular therapy (SFGM-TC)]. / Complications neurologiques post-allogreffe de cellules souches hématopoïétiques : recommandations de la Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC).

Neurological complications post-allogeneic hematopoietic stem cell transplantation are well-characterized; however, given their variable impact, they remain a significant cause of morbidity. The etiologies for these complications are vast. Causes may be linked to toxicity and infection or could be vascular or tumor-related. Regardless, these complications require early investigation, which is often multidisciplinary and hierarchical. Preventive measures may be considered in some situations. It is essential to respond early and quickly with a diagnosis and the appropriate therapeutic approach when faced with neurological complications. Focusing on the axes of etiology, diagnosis and treatment, this article offers a review of neurological complications post-allogeneic hematopoietic stem cell transplantation.

[Post-transplant pulmonary complications: Guidelines from the francophone Society of bone marrow transplantation and cellular therapy (SFGM-TC)]. / Complications pulmonaires post-greffe : recommandations de la Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC).

Pulmonary complications after allogeneic hematopoietic stem cell transplantation occur frequently (30-75%), vary in severity, and sometimes prove lethal. They may occur at an early stage post-transplant before D100 but may also surface later. Etiological support for these complications has shown a beneficial impact on survival. When faced with early complications, non-invasive tests, scans, and microbiological tests must be rapidly implemented. In the majority of cases, these tests facilitate diagnosis. In cases where microbiological non-invasive tests are negative, and the patient shows a steady respiratory condition, bronchoalveolar lavage can be effective if it is implemented in the first four days following the onset of pulmonary symptoms. This diagnostic approach should in no way occlude the introduction of broad-spectrum antibiotics in these profoundly immunocompromised patients. Later pulmonary complications are the most often not infectious. They include different anatomo-clinical conditions: cryptogenic organizing pneumonia; interstitial lung disease; idiopathic pleuroparenchymal fibroelastosis. Vascular disorders may include hypertension, thrombotic microangiopathy, venous thromboembolism, and pleural effusions. These conditions must be monitored using RFE (respiratory functional exploration) which allows early detection and therapeutic intervention. A combination of RFE and thoracic radiology scans will provide diagnostic assessment. Bronchoalveolar lavage is indicated when an infection is suspected or before systemic corticosteroid therapy. A lung biopsy should be discussed on a case-by-case basis, such as in cases of interstitial pulmonary disorders.