A. Enguita PhD

Medical need for patients with resistance to covalent Bruton tyrosine kinase inhibitors

Bruton tyrosine kinase inhibitors (BTKis) have revolutionised the treatment landscape for patients with chronic lymphocytic leukaemia (CLL) and several non-Hodgkin lymphoma (NHL) subtypes, including mantle cell lymphoma (MCL). Despite the efficacy of covalent BTKis (cBTKis), the development of resistance mutations leads to poor outcomes in patients who relapse after a cBTKi-based therapy. Non-covalent BTKis (ncBTKis), such as pirtobrutinib, have a different mode of action than cBTKis allowing them to overcome this acquired resistance. In recent years, several clinical trials have yielded promising results with pirtobrutinib and other ncBTKis in patients progressing on a cBTKi. This article zooms in on the unmet clinical needs of cBTKi-resistant patients, exploring pivotal findings from clinical trials assessing pirtobrutinib in this context, alongside other prospective strategies.

Haematological highlights from ESMO 2023

SUMMARY

Once more, the European Society for Medical Oncology (ESMO) dedicated a session to haematological malignancies during its last meeting in October 2023. This session revealed novel immunotherapeutic strategies, such as activating γ9δ2 T cells to treat haematological cancers and using trifunctional natural killer (NK) cell engagers to eliminate CD123+ tumour cells. Additionally, promising results were observed with the combination of toripalimab and radiotherapy in treating extranodal NK/T cell lymphoma. Furthermore, genetic analyses identified genetic alterations with prognostic value for anti-PD-1 therapy in peripheral T-cell lymphomas (PTCL). Finally, a large cohort study examined treatment outcomes in primary ocular adnexal MALT lymphoma (POAML) patients.

(BELG J HEMATOL 2024;15(2):62–5)

Journal scan

SUMMARY

In this section of the Belgian Journal of Hematology (BJH), we aim to provide a snapshot of pivotal studies published in recent issues of the most important international journals focusing on haematology. Importantly, the selection of the studies discussed here is the sole responsibility of the publisher and was not influenced by third parties. Do you miss an important study, or did you read a hidden jewel that deserves to be shared with your colleagues? Please, let us know (editor@bjh.be) and we will make sure to include it in the journal scan section of the next BJH issue.

(BELG J HEMATOL 2024;15(2):58–61)

Pierre Stryckmans Lecture – Hodgkin Lymphoma

The 2024 annual Pierre Stryckmans Lecture at BHS-GAM was presented by Prof. Dr. Peter Borchmann (German Hodgkin Study Group, University Hospital Cologne, Germany). The lecture, entitled ‘Hodgkin lymphoma’, offered an insightful overview of the disease immunological landscape and factors influencing treatment decision-making. Subsequently, Prof. Dr. Peter Borchmann guided us through a historical journey from early trials to recent studies and advancements, targeting both the early and late stages of the disease.

Addressing burnout and well-being in haematology

Burnout significantly affects the mental and physical health of physicians worldwide, a burden accentuated after the COVID-19 pandemic. During the second Special Lecture, Dr. Fay J. Hlubocky (University of Chicago Medicine, USA) discussed the current situation and the measures that can be taken to prevent or treat this syndrome in our daily haematology and oncology clinical practice.

VEXAS Syndrome: Current knowledge and management strategies

Described for the first time in 2020, VEXAS, an adult-onset ‘haemato-inflammatory syndrome’, is still largely unexplored. At the 2024 General Annual Meeting of the Belgian Hematology Society, Dr. Jérome Hadjadj (Hôpital Saint-Antoine, Paris, France) discussed the current understanding of this disease, covering its clinical manifestations, prognosis and potential treatments based on the knowledge available to date.

Advances in Laboratory Technology

For the “Advances in Laboratory Technology” session, the BHS invited two excellent scientists to discuss novel laboratory techniques that are ready – or almost ready – to enter routine haematological clinical practice. First, Prof. Tiziana Lazzarotto (University Hospital of Bologna, Sant’Orsola – Microbiology unit, Italy) walked us through the new methods for cytomegalovirus diagnosis in haematopoietic stem cell transplantation recipients, particularly in light of the new antiviral therapies. Subsequently, Prof. Jonathan Edgeworth (The Centre for Clinical Infection & Diagnostics Research, United Kingdom) discussed the new applications, challenges and clinical usefulness of the novel Nanopore technique in the diagnosis of infectious diseases in haematological patients.