Articles

Diagnosis and treatment of AL Amyloidosis in 2015: Consensus guidelines of the Belgian Hematological Society

BJH - volume 6, issue 5, december 2015

K. Beel MD, PhD, M.C. Vekemans MD, G. Bries MD, PhD, J. Caers MD, PhD, B. De Pryck MD, K. Fostier MD, A. Kentos MD, PhD, N. Meuleman MD, PhD, P. Mineur MD, I. Van de Broek MD, PhD, K.L. Wu MD, PhD, C. Doyen MD, M. Delforge MD, PhD

Summary

Immunoglobulin light chain amyloidosis is a clonal plasma cell dyscrasia, historically associated with a very poor prognosis. Prompt diagnosis is critical to preserve organ function and improve survival in immunoglobulin light chain amyloidosis patients. The severity of cardiac involvement and response to treatment are the most important prognostic factors. Serum free light chain ratio and cardiac biomarkers troponin T and N-terminal pro-brain natriuretic peptide are powerful tools for the evaluation of prognosis and treatment response. Historically, treatment with autologous stem cell transplantation appears to offer a survival benefit, but is only an option in a minority of patients. IMiDs, and especially proteasome inhibitors, have shown promising activity in immunoglobulin light chain amyloidosis. Supportive care should be integrated in the treatment plan and requires a multidisciplinary approach. These guidelines summarise a consensus of the myeloma subcommittee of the Belgian Hematological Society on diagnosis, cytoreductive and supportive treatment of immunoglobulin light chain amyloidosis, based on an extended review of the literature. Where applicable, comments were added with respect to the Belgian reimbursement modalities.

(BELG J HEMATOL 2015;6(5):187–94)

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Update on the initial therapy of multiple myeloma

BJH - volume 5, issue 4, december 2014

M.C. Vekemans MD, K. Beel MD, PhD, J. Caers MD, PhD, N. Meuleman MD, PhD, G. Bries MD, PhD, V. Delrieu MD, H. Demuynck MD, B. De Prijck MD, H. De Samblanx MD, A. Deweweire MD, A. Kentos MD, PhD, P. Mineur MD, F. Offner MD, PhD, I. Vande Broek MD, PhD, A. Vande Velde MD, J. Van Droogenbroeck MD, KL. Wu MD, PhD, C. Doyen MD, R. Schots MD, PhD, M. Delforge MD, PhD

Summary

With the introduction of immunomodulatory drugs and proteasome inhibitors, major improvements have been achieved in the treatment and prognosis of multiple myeloma. Different treatment combinations are now in use and innovative therapies are being developed. This rapidly changing therapeutic landscape calls for an update on the Belgian myeloma guidelines, published in 2010.1 Based on an extensive review of the recent literature, the myeloma study group of the Belgian Hematology Society has revised the consensus recommendations on myeloma care, to be used by haematologists as a reference for daily practice. When applicable, comments with regards to the Belgian reimbursement modalities are included. The full text with appendices can be downloaded from the Belgian Hematology Society website (www.bhs.be) and from the Belgium Journal of Hematology website (www.ariez.com).

(BELG J HEMATOL 2014;5(4):125–36)

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BHS guidelines for the treatment of marginal zone lymphomas

BJH - volume 5, issue 1, march 2014

D. Bron MD, PhD, E. Van den Neste MD, PhD, A. Kentos MD, PhD, F. Offner MD, PhD, W. Schroyens MD, PhD, C. Bonnet MD, A. Van Hoof MD, PhD, G. Verhoef MD, PhD, A. Janssens MD, PhD

Summary

Marginal zone lymphomas are a heterogeneous subtype of indolent B-non-Hodgkin Lymphoma that includes three distinct diseases: Extranodal mucosa associated lymphoid tissue lymphoma, nodal marginal zone lymphoma and splenic marginal zone lymphoma lymphocytes +/− villous lymphocytes. The different diagnosis, work up and treatment options are discussed in these guidelines.

(BELG J HEMATOL 2014;5(1):12–21)

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O.1 ABVD (8 cycles) vs. BEACOPP (4 escalated cycles => 4 baseline) in stage III – IV low risk Hodgkin Lymphoma (IPS 0–2): final results of LYSA H34 trial

BJH - volume 5, issue Abstract Book BHS, january 2014

M. André MD, PhD, B. De Prijck MD, A. Kentos MD, PhD, A. Van Hoof MD, PhD, C. Bonnet MD, A. Sonet MD, M. Maerevoet MD, E. Van den Neste MD, PhD, A. Bosly MD, PhD, N. Mounier

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Treatment of peripheral T-cell lymphomas: recommendations of the Belgian Hematological Society (BHS)

BJH - volume 4, issue 3, september 2013

F. Van Obbergh MD, A. Van Hoof MD, PhD, G. Verhoef MD, PhD, D. Dierickx MD, PhD, V. De Wilde MD, PhD, F. Offner MD, PhD, D. Bron MD, PhD, A. Sonet MD, M. André MD, PhD, A. Janssens MD, PhD, C. Bonnet MD, B. Deprijck MD, P. Zachée MD, PhD, A. Kentos MD, PhD, W. Schroyens MD, PhD, E. Van den Neste MD, PhD

Summary

The sub-committee on lymphoproliferative disorders of the Belgian Hematological Society has met several times to prepare guidelines on the management of patients with peripheral T-cell lymphomas. Each panellist’s expert provided interpretation of the evidence, based on literature review and personal experience. The available evidence was systematically discussed prior to formulating recommendations. A systematic approach to obtain consensus of expert opinion was used. After each meeting, the draft guideline was circulated to all experts for comment and approval. The present guidelines focus on general management of peripheral T-cell lymphomas with special emphasis on more specific disease-adapted strategies.

(BELG J HEMATOL 2013;4(3):90–101)

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Bilateral exophthalmia: first symptom of a Mantle-Cell Lymphoma

BJH - volume 3, issue 2, june 2012

M. Igala MD, B. Bailly MD, M.F. Dehou MD, S. Goldman MD, PhD, I. Vierasu MD, O. Pradier MD, PhD, A. Kentos MD, PhD, D. Bron MD, PhD

Summary

Mantle-cell lymphoma (MCL), located in the central nervous system (CNS) was first described some twenty years ago. It is a rare lymphoma usually diagnosed in the context of a resistant or recurring illness. We report the case of a patient in whom bilateral exophthalmia and palpebral ptosis were the first manifestations of a MCL with retro-orbital and meningeal infiltration.

(BELG J HEMATOL 2012;3:59–61)

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