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C. Bonnet MD

Articles

Updated BHS guidelines for the treatment of diffuse large B-cell lymphoma (DLBCL): Novelties anno 2024

BJH - volume 15, issue 4, june 2024

J. Brijs MD, M. André MD, PhD, S. Bailly MD, K. Beel MD, PhD, C. Bonnet MD, G. Crochet MD, P. De Paepe MD, PhD, D. Dierickx MD, PhD, C. Jacquy MD, PhD, K. Saevels MD, S. Snauwaert MD, PhD, E. Van den Neste MD, PhD, V. Vergote MD

SUMMARY

Diffuse large B-cell lymphoma (DLBCL) is an aggressive B-cell lymphoma and represents the most common subtype of B-cell non-Hodgkin lymphomas. The majority of patients (60–70%) can nowadays be cured with first line chemo-immunotherapy (CIT), mostly a combination of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). The remaining 30–40% of patients with relapsing or refractory (R/R) disease have an unfavourable prognosis. Until recently, these patients could only be cured with platinum-based salvage CIT followed by high-dose chemotherapy and an autologous stem cell transplantation, but with rather disappointing outcomes. However, new and promising treatments for these patients have now found their way into clinical practice, with good response and survival rates and manageable toxicity rates. This article will briefly review the latest advances in the treatment of DLBCL in Belgium, both for newly diagnosed disease and for R/R disease. We will focus on the role of polatuzumab vedotin in first line, chimeric antigen receptor (CAR) T-cell therapy in second line, tafasitamab-lenalidomide in second line or higher, and bispecific antibodies in third line or higher. New treatment algorithms, both for untreated and for R/R DLBCL, clinically oriented and adapted to the Belgian reimbursement criteria, are also presented.

(BELG J HEMATOL 2024;15(4):147–57)

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BHS guidelines on the management of relapsed and refractory diffuse large B-cell lymphoma: Part 2

BJH - volume 14, issue 4, june 2023

U. Douven MD, A. Janssens MD, PhD, G. Crochet MD, S. Bailly MD, C. Bonnet MD, C. Jacquy MD, PhD, F. Offner MD, PhD, S. Snauwaert MD, PhD, E. Van den Neste MD, PhD, M. Vercruyssen MD, D. Dierickx MD, PhD, P. Vandenberghe MD, PhD, V. Vergote MD

SUMMARY

Approximately 30–40% of patients with diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS), will relapse or are unable to obtain a complete remission (CR) after frontline treatment. These patients have a poor prognosis and represent a therapeutic challenge. In this article, we reviewed the recent literature to update the practice guidelines of the Belgian Hematology Society (BHS) Lymphoproliferative Disease Committee for the treatment of relapsed or refractory (R/R) DLBCL. In the first part, we will focus on first relapse and the role of CAR T-cell therapy in first and second relapse. In the second part, we will focus on novel treatment options for patients with a second or higher relapse, secondary central nervous system (CNS) relapse and high-grade lymphoma.

(BELG J HEMATOL 2023;14(4):170–7)

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BHS guidelines on the management of relapsed and refractory diffuse large B-cell lymphoma: Part 1

BJH - volume 14, issue 3, may 2023

U. Douven MD, A. Janssens MD, PhD, G. Crochet MD, S. Bailly MD, C. Bonnet MD, C. Jacquy MD, PhD, F. Offner MD, PhD, S. Snauwaert MD, PhD, E. Van den Neste MD, PhD, M. Vercruyssen MD, D. Dierickx MD, PhD, P. Vandenberghe MD, PhD, V. Vergote MD

SUMMARY

Approximately 30–40% of patients with diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS), will relapse or are unable to obtain a complete remission (CR) after frontline treatment. These patients have a poor prognosis and represent a therapeutic challenge. In this article, we reviewed the recent literature to update the practice guidelines of the Belgian Hematology Society (BHS) Lymphoproliferative Disease Committee for the treatment of relapsed or refractory (R/R) DLBCL. In the first part, we will focus on first relapse and the role of CAR T-cell therapy in first and second relapse. In the second part, we will focus on novel treatment options for patients with a second or higher relapse, secondary central nervous system (CNS) relapse and high-grade lymphoma.

(BELG J HEMATOL 2023;14(3):114–21)

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Diagnosis and treatment of peripheral T-cell lymphomas: Update recommendations of the Belgian Hematology Society (BHS)

BJH - 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

SUMMARY

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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BHS guidelines for the treatment of newly diagnosed diffuse large B-cell lymphoma (DLBCL) anno 2020

BJH - volume 11, issue 2, march 2020

G. Swennen MD, A. Janssens MD, PhD, V. Vergote MD, S. Bailly MD, C. Bonnet MD, E. Van den Neste MD, PhD, M. Maerevoet MD, S. Snauwaert MD, PhD, K. Saevels MD, C. Jacquy MD, PhD

SUMMARY

Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma. Prognosis of diffuse large B-cell lymphoma has improved dramatically since the introduction of rituximab and about two thirds of patients can be cured with immunochemotherapy. In the last twenty years, it became clear that diffuse large B-cell lymphoma is a very heterogeneous disease and based on the genetic mutation landscapes numerous efforts have been made to develop novel treatment strategies to improve the prognosis of diffuse large B-cell lymphoma further. This article provides an update of diagnosis, current treatment guidelines and novel treatment strategies for newly diagnosed patients with diffuse large B-cell lymphoma in Belgium. It will also focus on treatment of elderly patients and high-grade B-cell lymphoma.

(BELG J HEMATOL 2020;11(2):56–66)

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P.15 Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL): The Lymphoma Study Association (LYSA) Registry Data

BJH - volume 11, issue Abstract Book BHS, february 2020

M. André MD, PhD, F. Le Bras , P. Gaulard , C. Haioun , C. Laurent , M. Croix , J. Bonnefoy , F. Bouabbas , V. Fataccioli , C. Bonnet MD

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BHS guidelines for the treatment of marginal zone lymphomas: 2018 update

BJH - volume 10, issue 4, june 2019

D. Bron MD, PhD, M. Maerevoet MD, E. Van den Neste MD, PhD, V. Delrieu MD, F. Offner MD, PhD, W. Schroyens MD, PhD, A. Van Hoof MD, PhD, G. Verhoef MD, PhD, J.B. Giot MD, J.P. Loly MD, A. Janssens MD, PhD, C. Bonnet MD

Marginal zone lymphomas (MZL) are a heterogeneous subtype of indolent B-non-Hodgkin lymphomas that includes distinct entities:

  • Extranodal mucosa-associated lymphoid tissue lymphoma arises in a variety of tissue but primarily in the stomach. They are usually localised and often associated with chronic antigenic stimulation by microbial pathogens. Eradication of the pathogen is a major part of the first-line therapy. The prognosis is excellent in early stages. In advanced stages, observation, anti-CD20 antibodies and/or cytostatic drugs are therapeutical approaches.
  • Nodal MZL is usually confined in lymph nodes, bone marrow and peripheral blood. The prognosis is somewhat worse in this entity. Current recommendations suggest that they should be managed as follicular lymphomas.
  • Splenic MZL is a unique entity involving the spleen, bone marrow and blood. Hepatitis infection should be eradicated before considering treatment. These lymphomas have an indolent behaviour, and only symptomatic patients should be treated by splenectomy and/or anti-CD20 antibodies.
  • Two novel entities are described, non-chronic lymphocytic leukaemia monoclonal B-cell lymphocytosis, probably closely related to splenic MZL lymphoma, and a less well-defined provisional entity involving primarily the spleen called splenic B-cell lymphoma/leukaemia, unclassifiable, including splenic diffuse red pulp lymphoma and hairy-cell leukaemia variant.

This review will discuss separately the diagnosis, work-up and treatment of extranodal mucosa-associated lymphoid tissue lymphoma, nodal MZL and splenic MZL. These guidelines include the recently published ESMO consensus conference on malignant lymphoma.1–3

(BELG J HEMATOL 2019;10(4):153–64)

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