C. Lambert MD, PhD

The role of thrombopoietin receptor agonists in the management of chemotherapy-induced thrombocytopenia

SUMMARY

Chemotherapy-induced thrombocytopenia (CIT) is a common complication of cancer treatment that poses a severe clinical burden to patients with solid or haematologic malignancies. As this thrombocytopenia can present a barrier to continue chemotherapy at full dose and on schedule, it can hamper the patient’s long-term oncologic outcomes. Despite the clinical challenges related to CIT, there are currently no available agents approved by the FDA or EMA for the treatment or prevention of CIT. However, treatment with thrombopoietin receptor agonists (TPO-RAs) may increase platelet counts and benefit the safe administration of full-dose chemotherapy without dose delays. This not only reduces the patient’s bleeding risks, but also benefits the long-term oncologic outcomes. To date, most evidence for the use of TPO-RAs in the setting of CIT come from trials with romiplostim.

(BELG J HEMATOL 2024;15(3):94–102)

Primary immune thrombocytopenia in adults: Belgian recommendations for diagnosis and treatment anno 2021 made by the Belgian Hematology Society

SUMMARY

The Belgian Hematology Society (BHS) updated the 2013 guidelines for diagnosis and treatment of primary immune thrombocytopenia (ITP).¹ As knowledge about ITP pathophysiology is increasing, the mode of action of old therapies is better understood and novel drugs are introduced to target more specific pathways. Corticosteroids with or without intravenous immunoglobulins (IgIV) remain the first line treatment. According to the updated international guidelines, a short course of corticosteroids rather than a prolonged treatment has to be recommended. The same guidelines stress that consequent therapies as thrombopoietic agents (TPO-RAs) and rituximab should be available independent of duration of ITP. Although the majority of recommendations is based on very low-quality evidence, it is strongly advised to individualise the ITP management taking patient values and preferences in account. The main treatment goal in all ITP patients must be to maintain a safe platelet count to prevent or stop bleeding with a minimum of toxicity and not to normalise the platelet count.

(BELG J HEMATOL 2020;12(3):112-27)

Non-substitutive strategies to improve haemophilia care in developing countries: Experience in Côte d’Ivoire

SUMMARY

In developing countries, the high rate of haemophilia-related mortality and morbidity is mainly caused by a lack of knowledge, underdiagnoses and very limited access to treatment. This work carried out in Côte d’Ivoire as a part of the World Federation of Hemophilia twinning program, aimed to evaluate the impact of non-substitutive strategies (not based on concentrates of coagulation factors) on the management of haemophilia. This project sought at developing and validating education materials to improve knowledge on haemophilia, implementing a self-physiotherapy program, and obtaining cross-cultural and validated tools to assess the quality of life of people with haemophilia. These initiatives were the starting point for haemophilia care in Côte d’Ivoire, by providing patients with low-cost measures and creating an environment favourable for the use of substitutive treatment issued from humanitarian aid. This thesis was defended at UCLouvain on September 01, 2020. The full manuscript of this these is available on dial.uclouvain.be.

(BELG J HEMATOL 2020;12(2):90-2)

O.5 Confirmation of the very low rate of subclinical venous thrombosis in people with hemophilia undergoing major orthopedic surgery in the absence of pharmacological thromboprophylaxis

Management of immune thrombocytopenia in multiple sclerosis patients treated with alemtuzumab: a Belgian consensus

SUMMARY

Alemtuzumab (Lemtrada®) is a humanised monoclonal antibody indicated for the treatment of adult patients with relapsing/remitting multiple sclerosis with active disease defined by clinical or imaging features. Alemtuzumab demonstrated superior efficacy over active comparator in both treatment naive patients and those with inadequate response to prior therapy. Alemtuzumab is associated with a consistent and manageable safety and tolerability profile. Treatment with alemtuzumab for multiple sclerosis increases the risk for autoimmune adverse events including immune thrombocytopenia. Complete blood counts with differential should be obtained prior to initiation of treatment and at monthly intervals thereafter for 48 months after the last infusion. After this period of time, testing should be performed based on clinical findings suggestive of immune thrombocytopenia. If immune thrombocytopenia onset is confirmed, appropriate medical intervention should be promptly initiated, including immediate referral to a specialist. This paper presents the consensus of Belgian multiple sclerosis specialists and haematologists to guide the treating physician with practical recommendations.

(BELG J HEMATOL 2018;9(3):118–23)

A-138 DEVELOPMENT OF APPROPRIATE AND CULTURALLY ADAPTED EDUCATIONAL TOOLS ON HAEMOPHILIA FOR THE PATIENTS FROM IVORY COAST AND THEIR FAMILIES

A-131 SUCCESSFUL AND COST-EFFECTIVE USE OF FC-FUSED FIX DURING MAJOR ORTHOPAEDIC SURGERY