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Abstract：
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.
摘要：
异基因造血干细胞移植后肺部并发症经常发生（30-75％），严重程度不同，有时被证明是致命的。它们可能在D100之前的移植后早期发生，但也可能在以后出现。对这些并发症的病因支持已显示出对生存的有益影响。当面临早期并发症时，非侵入性测试，扫描,和微生物测试必须迅速实施。在大多数情况下,这些测试有助于诊断。在微生物非侵入性测试为阴性的情况下，病人表现出稳定的呼吸状况，如果在出现肺部症状后的前四天内实施支气管肺泡灌洗，则可以有效。这种诊断方法绝不应阻碍在这些严重免疫功能低下的患者中引入广谱抗生素。后来的肺部并发症是最常见的非传染性的。它们包括不同的解剖临床条件：隐源性机化性肺炎；间质性肺病；特发性胸膜实质纤维弹变性。血管疾病可能包括高血压，血栓性微血管病,静脉血栓栓塞,和胸腔积液.必须使用允许早期检测和治疗干预的RFE(呼吸功能探查)来监测这些状况。RFE和胸部放射学扫描的组合将提供诊断评估。当怀疑感染或全身皮质类固醇治疗之前，应进行支气管肺泡灌洗。肺活检应根据具体情况进行讨论，例如间质性肺病的病例。
