BJH - volume 14, issue 2, march 2023
J. Brijs MD, J. Neefs PharmD, A. Janssens MD, PhD
Lymphomas are the most common haematological malignancy and represent a heterogenous group of lymphoproliferative diseases with a variable prognosis. Chemotherapy and radiotherapy, and anti-CD20 immunotherapy for B-cell lymphomas, currently form the basis of lymphoma treatment. New agents, especially new forms of cancer immunotherapy, such as bispecific antibodies (bsAbs), have expanded therapeutic approaches in the last years. bsAbs have two different antigen binding sites, which enables them to simultaneously target tumour cells and immune effector cells (T-cells). By binding and activating T-cells in the proximity of tumour cells, an effective T-cell mediated anti-tumour response can be achieved. Target antigens in lymphomas are mostly CD19 or CD20 on the malignant B-cell and CD3 on the T-cell. This article will briefly review the basic principles and mechanisms of action of bsAbs, discuss the molecules approved or in advanced clinical development for lymphomas with their most relevant (dose-escalation/dose-expansion) trials, and pay attention to possible adverse events and future perspectives of bsAbs.
(BELG J HEMATOL 2023;14(2):67–72)
Read moreBJH - volume 13, issue 7, november 2022
T. Mercier MD, PhD, S. Fieuws PhD, K. Theunissen MD, M-C. Ngirabacu MD, PhD, N. Straetmans MD, PhD, C. Spilleboudt MD, D. Mazure MD, V. De Wilde MD, PhD, A. De Becker MD, D. Selleslag MD, D. Breems MD, PhD, D. Deeren MD, S. Servais MD, PhD, C. Jacquy MD, PhD, H. Poirel MD, PhD, D. Van Beckhoven MD, K. Blot MD, PhD, A. Janssens MD, PhD, H. Schoemans MD, PhD
In the early weeks of the ongoing COVID-19 pandemic, little was known about the risk factors of this novel disease in haematology patients. We therefore created a national, multi-center, retrospective study via a national consortium of haematology centres in Belgium to investigate the incidence and clinical characteristics of COVID-19 in haematology patients. By combining these data with data collected through the national public health institute Sciensano and the national Belgian Cancer Registry, we were able to show that haematology patients were at an increased risk of being hospitalised with COVID-19 (1 in 250 haematology patients versus 1 in 2000 in the general population). Furthermore, we found that patients with multiple myeloma and acute leukaemia were overrepresented in these hospitalisations. Mortality at 90 days was 38% during the first wave, compared to 19.3% in the general population. We therefore conclude that haematology patients with COVID-19 are at a significantly higher risk of both hospitalisation and death.
(BELG J HEMATOL 2022;13(7):269–76)
Read moreBJH - volume 13, issue 6, october 2022
C. Debergh MD, A. Janssens MD, PhD, D. Dierickx MD, PhD, R. Van Ginderdeuren MD, T. Tousseyn MD, PhD, J. Van Calster MD, V. Vergote MD
BACKGROUND: Primary vitreoretinal lymphoma (PVRL) is a rare and difficult to diagnose lymphoma. The goal of this retrospective monocentric study was to obtain clinical characteristics, to evaluate median time to diagnosis, different treatment modalities and survival outcomes.
METHODS: PVRL cases were selected from the database of the University Hospitals Leuven (Belgium) from 1st January 2012 until 1st January 2021. A review of the available literature was performed.
RESULTS: We included eleven cases of PVRL with a median age of 76 years (Interquartile range (IQR): 68–81). Median time to diagnosis was seven months (Range: 3–16). Presenting symptoms were blurred vision (n=11, 100%) and floaters (n=3, 27%). Bilateral eye involvement was seen in 42% (n=5). Diagnosis was made by vitrectomy and immunocytochemistry in all cases. Histopathological diagnosis was diffuse large B-cell lymphoma in all cases. Flow cytometry was used in 55% (n=6) of patients to confirm diagnosis. Initial treatment included local therapy in all patients. A combination of local and systemic therapy was given to three patients (27%). Seven patients (64%) were diagnosed with CNS relapse. No systemic relapse was seen. Median progression-free survival (PFS) and overall survival (OS) were ten (IQR: 6–32) and 26 months (IQR: 12–37). Median PFS of patients treated with local versus combined therapy was 9.7 and 18 months, respectively. However, OS of patients with local versus combination therapy was 29 and 19 months, respectively.
CONCLUSION: We analysed the clinical characteristics of eleven patients with PVRL in our hospital. The majority of these cases will eventually progress to CNS lymphoma. We saw a prolonged PFS for patients treated with combination therapy in first-line, compared to local therapy alone. However, OS was longer in patients treated with local therapy only. Despite the small cohort, these results are comparable to previous literature. Based on larger retrospective studies we conclude that local therapy as first line treatment in PVRL results in similar OS rates with less systemic toxicity compared to combination therapy.
(BELG J HEMATOL 2022;13(6):228–235)
Read moreBJH - volume 13, issue 4, june 2022
T. Van Nieuwenhuyse PharmD, A. Janssens MD, PhD
Bruton’s tyrosine kinase (BTK) inhibitors have demonstrated impressive clinical activity and tolerability in several B-cell malignancies, both as single agent or in combination with anti-CD20 monoclonal antibodies. Acalabrutinib, a next-generation BTK inhibitor, has been reimbursed recently by the Belgian national public health insurance for the treatment of chronic lymphocytic leukaemia (CLL). This review describes mechanism of action, dosage and administration, efficacy, and tolerability.
(BELG J HEMATOL 2022;13(4):156–64)
Read moreBJH - volume 13, issue 4, june 2022
M. Janssens MD, K. Saevels MD, V. Vergote MD, J. Lemmens MD, S. Bailly MD, A. Janssens MD, PhD, S. Snauwaert MD, PhD, M. André MD, PhD
Besides disease-directed therapy, patients with lymphoma are in need of a wide range of supportive measures. In the second part of this guideline, the prevention and treatment of tumour lysis syndrome, cardiac support and physiotherapy are discussed.
(BELG J HEMATOL 2022;13(4):149–55)
Read moreBJH - volume 13, issue 3, may 2022
M. Janssens MD, K. Saevels MD, V. Vergote MD, J. Lemmens MD, S. Bailly MD, A. Janssens MD, PhD, S. Snauwaert MD, PhD, M. André MD, PhD
Besides disease-directed therapy, patients with lymphoma are in need of a wide range of supportive measures. In the first part of this guideline the use of anti-emetic therapy, the use of granulocyte colony stimulating factor (G-CSF) and antibiotic prophylaxis for pneumocystis jirovecii are discussed. In part 2 of this guideline we will discuss cardiac support, prevention and treatment of tumour lysis syndrome and the role of physiotherapy.
(BELG J HEMATOL 2022;13(3):116–23)
Read moreBJH - volume 13, issue 2, march 2022
A. Wolfromm MD, S. Bailly MD, E. Van den Neste MD, PhD, M. André MD, PhD, K. Saevels MD, H. Antoine-Poirel MD, PhD, T. Tousseyn MD, PhD, V. Van Hende MD, S. Snauwaert MD, PhD, A. Janssens MD, PhD, C. Jacquy MD, PhD, C. Bonnet MD
Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive diseases associated with poor outcomes. Recent progress in understanding of the biology and pathogenesis based on molecular profiling and next-generation sequencing has led to the introduction of new provisional entities in the World Health Organization (WHO) classification system of 2017 and to the emergence of new drugs.1 Previous Belgian guidelines were published in 2013.2 This review will discuss the diagnosis, work-up and treatment of PTCL including these advances as well as the limitation of the availability of drugs according to the Belgian reimbursement rules.
(BELG J HEMATOL 2022;13(2):65–80)
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