A. Enguita PhD

Management of myelofibrosis: Novel approaches and recent evolutions

Myelofibrosis (MF) is a chronic malignancy characterised by marrow fibrosis and myeloproliferation caused by a constitutive activation of the Janus-activated kinase (JAK) transcription signalling pathway. This constitutive activation is usually the result of mutations in the driver genes JAK2, myeloproliferative leukaemia virus (MPL) or calreticulin (CALR).¹ The most important clinical manifestation of MF consists of splenomegaly, in addition to hepatomegaly, cytopenia (mainly anaemia), and constitutional symptoms.² MF significantly decreases the life expectancy of patients with a median survival of less than six years.³ During the 37^th general annual meeting of the Belgian Haematology Society, professor Jean-Jacques Kiladjian (Saint Louis Hospital, Paris, France) discussed the contemporary management of this disease.

Bringing care to the patient, anywhere, anytime

During the 37^th general annual meeting of the Belgian Haematology Society, Prof. Koen Kas, (University Hospital Ghent, Ghent, Belgium) provided some insights into the future of healthcare. In this future, hospital care will increasingly be substituted for home care in which patients will be monitored and treated 24/7 within the comfort of their home. In this way, healthcare can be brought to the patient anywhere, at any time. The first teleconsultation took place in 1924 (Teleheath 1924) and was seen as a revolutionary way to bring healthcare to the people.¹ Early in 2020, the number of teleconsultations increased enormously as a result of the SARS-Cov-2 pandemic. However, the use of teleconsultations decreased again in the second half of the year in parallel with an improvement in the pandemic situation. It has now reached a new equilibrium: there are still more teleconsultations than before the COVID-19 pandemic, but less than during its peak (Figure 1).² Nowadays, still 62% of patients feel that teleconsultations should remain an exception. However, with the emergence of new technological developments this perception is rapidly changing.³

Paradigm shifts in managing infections in high-risk haematology patients

High-risk haematology patients present with a partial or totally disintegrated immune system. Consequently, infections remain one of the main causes of morbidity and mortality among these patients. During the 37th general annual meeting of the Belgian Haematology Society, Prof. Johan Maertens (University Hospital Leuven, Leuven, Belgium), walked us through the current advances in the management of infections in high-risk haematology patients, with a focus on patients undergoing aggressive chemotherapy for any type of leukaemia and allogenic non-transplanted siblings.

Haematological echoes from ESMO 2022

SUMMARY

While the annual meeting of the European Society for Medical Oncology (ESMO) of course mainly focusses on advances in solid tumours, this year’s edition also featured a session zooming on haematological malignancies. In this session, encouraging results were presented for the combination of lemzoparlimab, a CD47 antibody, with azacytidine, in the treatment of patients with myelodysplastic syndromes. In addition, also the new anti-CD20-MMAE antibody-drug conjugate TRS005 displayed promising activity in patients with relapsed/refractory (R/R) B-cell non-Hodgkin lymphoma. Finally, two interesting studies were presented using novel CAR-T constructs, one CAR-T expressing a PD1 knock-down gene for the treatment of CD19+ B cell malignancies, and a second CAR-T construct targeting BCMA, for the treatment of R/R myeloma.

(BELG J HEMATOL 2022;13(8):333–6)