A. Janssens MD, PhD

P37 Comparison of Multigam^® IV (5% vs. 10%) in hematological patients with secondary immunodeficiencies to evaluate infusion time, tolerability and satisfaction. A monocentric observational Belgian study

Venetoclax, the first available bcl-2 antagonist for chronic lymphocytic leukaemia

SUMMARY

Venetoclax, the first-in-class bcl-2 antagonist, has demonstrated deep and durable remissions as a single agent in relapse/refractory chronic lymphocytic leukaemia patients with a 17p deletion or chronic lymphocytic leukaemia refractory to B-cell receptor inhibitors or progressive after B-cell receptor inhibitor discontinuation. As reimbursement of venetoclax by the Belgian national public health insurance has been provided, this review describes mechanism of action, dosage and administration, efficacy and tolerability. As venetoclax can rapidly reduce the chronic lymphocytic leukaemia load, precautions to avoid tumour lysis syndrome depending on risk assessment is a sine qua non. Despite the convenience afforded by this oral, once daily formulation, treating physicians and patients must be aware of drug adherence and drug-drug interactions which can challenge treatment benefits and risks.

(BELG J HEMATOL 2017;8(7):265–71)

CNS prophylaxis in aggressive non-Hodgkin’s lymphoma

SUMMARY

Although it doesn’t occur frequently, central nervous system relapse in aggressive non-Hodgkin lymphoma carries a very dismal prognosis. Indications for the use of prophylactic strategies are clear-cut in Burkitt and lymphoblastic lymphoma. However, this remains subject to much debate in other types of aggressive non-Hodgkin lymphoma, like diffuse large B-cell lymphoma. Available strategies consist of intrathecal administration of chemotherapy, the systemic use of high-dose central nervous system-penetrating cytotoxic agents or a combination of both. Nevertheless, all known methods entail a certain risk for toxicity in patients. Hence, great effort has been put in the search for risk factors and scores to identify high-risk patients who have benefit from central nervous system-prophylaxis and to exclude those who do not. This article aims to provide an overview of existing strategies, pharmacological properties and side effects of available cytotoxic agents, as well as an update on the current guidelines for the implementation of central nervous system prophylaxis in different types of non-Hodgkin lymphoma. However, due to lack of qualitative prospective data, a golden standard in this field is still lacking.

(BELG J HEMATOL 2017;8(6):232–8)

BHS guidelines for the diagnosis and the treatment of hairy cell leukaemia

SUMMARY

Hairy cell leukaemia is a rare chronic B-cell lymphoproliferative disorder characterised by a long natural course with, in most of cases, an excellent response to a single course of purine analogue monochemotherapy. Making the right diagnosis, excluding the chemo resistant variant form of hairy cell leukaemia, and making progresses in the treatment of relapsing and/or refractory disease remains challenging up to date. In recent years, exciting results with new agents are emerging and clinical trials are ongoing to optimize the management of hairy cell leukaemia and its variant form.

(BELG J HEMATOL 2017;8(6):222–8)

Highlights in chronic lymphocytic leukemia

SUMMARY

This report will summarize useful clinical updates for the management of chronic lymphocytic leukemia (CLL) presented during the biannual International Workshop on Chronic Lymphocytic Leukemia (iwCLL, New York, May 12–15 2017), the 2017 International Conference on Malignant Lymphoma (ICML; Lugano June 14–17) and the 2017 annual meeting of the European Hematology Association (EHA; Madrid June 22–25).

(BELG J HEMATOL 2017;8(4):129–32)

P37 CD123 expression on acute leukemia blasts, hematogones, and monocytes; used as Minimal Residual Disease Marker

P15 Treatment patterns of Waldenström’s macroglobulinemia in Belgium