BJH - volume 6, issue 5, december 2015
A. Janssens MD, PhD, E. Van den Neste MD, PhD, F. Offner MD, PhD, D. Bron MD, PhD
The Belgian Hematological Society Lymphoproliferative Working Party updated the 2012 recommendations on the best strategies for front-line and subsequent-line treatment of small lymphocytic leukaemia/chronic lymphocytic leukaemia. No treatment is necessary for patients without active and/or advanced disease, regardless of prognostic factors. When front-line treatment is indicated we recommend adding an anti-CD20 monoclonal antibody to chemotherapy except in frail patients: fludarabine, cyclophosphamide, rituximab for fit patients; bendamustine, rituximab for fit patients >65 years or unfit for fludarabine, cyclophosphamide, rituximab; and chlorambucil with obinutuzumab or rituximab for older patients with a geriatric profile, major comorbidities or a reduced performance status. The choice of treatment for patients with recurrent disease depends on the duration of response to the previous treatment, the type of treatment refractoriness and the presence of a 17p deletion/p53 mutation. As an alternative, chemoimmunotherapy can be proposed for patients with a late relapse. The novel B-cell receptor inhibitors are the best choice for those relapsing early, who have refractory disease or are unfit for chemoimmunotherapy. The B-cell receptor inhibitors are also first choice for each patient with a de novo or acquired 17p deletion/p53 mutation. Reduced intensity conditioning allogeneic stem cell transplantation should still be considered for patients with high-risk disease after response induction by the B-cell receptor inhibitors. We still have to encourage patients to enter clinical trials exploring new drug combinations.
(BELG J HEMATOL 2015;6(5): 195–202)
Read moreBJH - volume 6, issue 5, december 2015
A. Janssens MD, PhD
The first-in-class Bruton’s tyrosine kinase and phosphatidylinositol-3-kinase delta inhibitors have demonstrated impressive clinical activity and tolerability in several B-cell malignancies, both as single agent or in combination with rituximab. As reimbursement of ibrutinib and idelalisib by the Belgian national public health insurance has been granted, this review describes mechanism of action, dosage and administration, efficacy and tolerability. Although both molecules show a very favourable toxicity profile, treating physicians and patients must be aware of some medical events of interest.
(BELG J HEMATOL 2015;6(5):216–24)
Read moreBJH - volume 6, issue 4, october 2015
V. Van Hende MD, D. Bron MD, PhD, E. Van den Neste MD, PhD, C. Bonnet MD, M. André MD, PhD, A. Van Hoof MD, PhD, D. Dierickx MD, PhD, G. Verhoef MD, PhD, T. Tousseyn MD, PhD, A. Janssens MD, PhD, V. De Wilde MD, PhD, K.L. Wu MD, PhD, P. Heimann MD, PhD
Waldenström’s macroglobulinaemia is a B-cell disorder characterised by bone marrow infiltration with lymphoplasmacytic cells, along with demonstration of an IgM monoclonal gammopathy in the blood. This condition belongs to the lymphoplasmacytic lymphomas as defined by the World Health Organization classification (ICD-0 code 9671/3). Approximately one-fourth of patients are asymptomatic. Clinical features of the symptomatic patients are diverse and may relate to overall disease burden (such as peripheral blood cytopaenias, organomegaly and constitutional symptoms) or may be directly attributable to the IgM paraprotein. The latter include hyperviscosity syndrome, amyloidosis, peripheral neuropathy and cold haemagglutinin. Therapeutic options have traditionally involved alkylating agents, nucleoside analogues, and rituximab, either as single therapy or in combination. However, emerging new data on combination therapy as well as novel agents have shown encouraging results. This report provides the Belgian Hematology Society guidelines according to recent clinical studies.
(BELG J HEMATOL 2015;6(4):142–50)
Read moreBJH - volume 6, issue 2, may 2015
C. Bonnet MD, A. Janssens MD, PhD, K.L. Wu MD, PhD, W. Schroyens MD, PhD, V. Van Hende MD, P. Heimann MD, PhD, T. Tousseyn MD, PhD, M. André MD, PhD, D. Bron MD, PhD, A. Van Hoof MD, PhD, G. Verhoef MD, PhD, B. De Prijck MD, Y. Beguin MD, PhD, D. Dierickx MD, PhD
Burkitt’s lymphoma is a rare but very aggressive non-Hodgkin’s lymphoma characterised by an isolated translocation t(8;14)(q24;q32). The sporadic form is the sub-entity most frequently encountered in Belgium. Diagnosis and initial work-up must be completed rapidly to start treatment as soon as possible. Positron emission tomography scan is useful for initial staging and to evaluate the chemosensitivity of the tumour during and after treatment. After debulking, it is recommended to add rituximab to chemotherapy. Currently intensive short-cycle and low intensity chemotherapies are two valuable options. Radiotherapy is not indicated except in case of central nervous system involvement. Patients achieving complete remission must be followed carefully during the first year to detect recurrence of the disease. More than 80% of patients sustain their remission one year following initial treatment and are considered cured. For patients in partial remission or with chemosensitive relapse, autologous stem cell transplantation is recommended following re-induction with non-cross-resistant polychemotherapy. Monitoring complete blood counts and cognitive functions is important to detect late toxicity of the applied therapies.
(BELG J HEMATOL 2015;6(2):61–9)
Read moreBJH - volume 6, issue Abstract Book BHS, january 2015
V. Vergote MD, A. Janssens MD, PhD, A. Van Hoof MD, PhD, All Other Members of The BHS
BJH - volume 6, issue Abstract Book BHS, january 2015
D. Dierickx MD, PhD, K. Saevels MD, G. Verhoef MD, PhD, M. Delforge MD, PhD, T. Devos MD, PhD, A. Janssens MD, PhD, J. Maertens MD, PhD, H. Schoemans MD, PhD
BJH - volume 6, issue Abstract Book BHS, january 2015
A. Janssens MD, PhD, V. Vergote MD, A. Van Hoof MD, PhD, All Other Members of The BHS
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