[Diet guidelines in adult and pediatric patient after allogeneic stem cell transplantation (SFGM-TC)]. / Consignes alimentaires pour les patients adultes et pédiatriques en sortie d'hospitalisation post-allogreffe de cellules souches hématopoïétiques (SFGM-TC).

The nutritional status after bone marrow transplant plays an important role in the outcome of patients. Post-allograft dietary instructions are therefore essential to ensure quality nutrition while minimizing the risk of infection. For patients, this is one of their main concerns on discharge from hospital. With the aim of harmonizing post-allograft dietary instructions, a multidisciplinary working group has been set up within a number of French centers performing hematopoietic stem cell allogenic transplantation. The dietary guidelines have been updated by this working group, through videoconference meetings, an online questionnaire, a review of the literature and deliberations at harmonization days. These instructions will be incorporated into the next update of the adult and pediatric post-transplant follow-up booklet.

Long term outcome of laryngeal mobility disorder and quality of life after pediatric cardiac surgery.

INTRODUCTION: Laryngeal mobility disorder after a pediatric heart surgery is common (between 5 and 10% of cases), and has important consequences on swallowing, breathing and speaking. After reviewing the literature, the recovery rate is variable and the postoperative follow-up is often done on a short time frame. The primary objective of the study is to describe the recovery from laryngeal mobility disorder with a follow-up time of at least 5 years. The secondary objective is to describe of the quality of life of the child in terms of phonation and swallowing, and to identify potential risk factors for a lasting laryngeal mobility disorder. METHODS: We collected data (morphological characteristics and details of the procedures and medical care) on children who had undergone a heart surgery with risks of complications, between 2010 and 2015, and with a laryngeal mobility disorder detected after the surgery through nasal flexible laryngoscopy. During a follow-up consultation, carried at least 5 years after the surgery, we performed a nasal flexible laryngoscopy to assess whether or not the patient had recovered a full mobility of the larynx. Two questionnaires were also given to the patients, the pVHI and the PEDI EAT-10, to assess respectively the quality of their speech and of their swallowing function. RESULTS: The recovery rate for a laryngeal mobility disorder more than 5 years after surgery was found to be 65% (9 children out of the 14 included in the study). We identified a risk factor for the persistence of a laryngeal mobility disorder after surgery: the presence of an associated genetic syndrome, p = 0.025. Children with persistent laryngeal mobility disorder have an impaired quality of life score, using the pVHI scale, which correlates well with the flexible laryngoscopy findings, p = 0.033. CONCLUSION: Children with a lasting laryngeal mobility disorder have disabling respiratory and vocal symptoms in their daily lives. Nasal flexible laryngoscopy should therefore be systematically performed postoperatively after a surgery carrying risks. For improved patient management, early detection of these disorders by pharyngolaryngeal nasal flexible laryngoscopy in the aftermath of high-risk cardiac surgery is strongly advised, with prolonged follow-up.

[Nutritional management for patients hospitalized during allogeneic stem cell transplantation: Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)]. / Prise en charge nutritionnelle des patients hospitalisés pour allogreffe de CSH : recommandations de la Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC).

Allogeneic haematopoietic stem-cell transplantation is usually applied with success for patients with diseases involving bone marrow and associated with frequent and severe malnutrition. Denutrition is an independent survival factor and contribute to transplant-related mortality. Due to the heaviness of the treatment, this event is frequent. Before allogeneic transplantation, the nutritional statute should be evaluated. The adult or pediatric patient's evaluation modalities and nutritional needs are detailed in this paper. The administration modalities (enteral or parenteral) with doses are specifically precise. We also explain why the enteral nutritional support may remain the best option comparing to parenteral option.