BJH - volume 14, issue 3, may 2023
J. Nelissen MD, K.L. Wu MD, PhD, N. Granacher MD, D. Breems MD, PhD
Hereditary haemorrhagic telangiectasia (HHT) is a rare genetic disorder that causes mucocutaneous telangiectasia and visceral arteriovenous malformations (AVMs). Recurrent iron deficiency and anaemia are significant complications often treated by haematologists. Bevacizumab, an anti-VEGF monoclonal antibody, has been implemented to target elevated levels of VEGF as seen in HHT patients. We present a single centre case series of three patients with recurrent bleeding issues due to HHT who have been treated with bevacizumab. All three patients were benefited in terms of mean haemoglobin, need for iron infusions and number of haemostatic interventions. Based on our own case series and existing literature, systemic bevacizumab appears to be effective in the treatment of bleeding-related conditions. However, the optimal dose and treatment strategy has yet to be determined. Randomised controlled studies are needed to further support the indication of bevacizumab in HHT.
(BELG J HEMATOL 2023;14(3):135–8)
Read moreBJH - volume 14, issue 2, march 2023
I. Moors MD, D. Deeren MD, C. Jacquy MD, PhD, A. Jaspers MD, PhD, T. Kerre MD, PhD, V. Havelange MD, PhD, D. Selleslag MD, C. Spilleboudt MD, N. Straetmans MD, PhD, F. Van Obbergh MD, A. De Voeght MD, S. Anguille MD, PhD, A. Schauwvlieghe MD, PhD, N. De Beule MD, PhD, A. De Becker MD, D. Breems MD, PhD
Acute myeloid leukaemia is an aggressive form of bone marrow cancer with poor prognosis, especially in elderly, unfit patients. The VIALE-A study showed an impressive improvement in complete remission rate and overall survival with the addition of venetoclax, a BCL-2 inhibitor, to azacitidine. This combination therapy is now reimbursed in Belgium for newly diagnosed adult AML patients who are considered unfit for intensive chemotherapy based on age and/or comorbidities. In this article, we provide recommendations on the use of this new combination, as well as on prophylaxis and management of specific side effects.
(BELG J HEMATOL 2023;14(2):59–66)
Read moreBJH - volume 13, issue 7, november 2022
T. Mercier MD, PhD, S. Fieuws PhD, K. Theunissen MD, M-C. Ngirabacu MD, PhD, N. Straetmans MD, PhD, C. Spilleboudt MD, D. Mazure MD, V. De Wilde MD, PhD, A. De Becker MD, D. Selleslag MD, D. Breems MD, PhD, D. Deeren MD, S. Servais MD, PhD, C. Jacquy MD, PhD, H. Poirel MD, PhD, D. Van Beckhoven MD, K. Blot MD, PhD, A. Janssens MD, PhD, H. Schoemans MD, PhD
In the early weeks of the ongoing COVID-19 pandemic, little was known about the risk factors of this novel disease in haematology patients. We therefore created a national, multi-center, retrospective study via a national consortium of haematology centres in Belgium to investigate the incidence and clinical characteristics of COVID-19 in haematology patients. By combining these data with data collected through the national public health institute Sciensano and the national Belgian Cancer Registry, we were able to show that haematology patients were at an increased risk of being hospitalised with COVID-19 (1 in 250 haematology patients versus 1 in 2000 in the general population). Furthermore, we found that patients with multiple myeloma and acute leukaemia were overrepresented in these hospitalisations. Mortality at 90 days was 38% during the first wave, compared to 19.3% in the general population. We therefore conclude that haematology patients with COVID-19 are at a significantly higher risk of both hospitalisation and death.
(BELG J HEMATOL 2022;13(7):269–76)
Read moreBJH - volume 11, issue 7, november 2020
S. Kennes MD, I. Moors MD, dr. A. Delie MD, S. Anguille MD, PhD, D. Breems MD, PhD, D. Selleslag MD, T. Kerre MD, PhD
In hyperleukocytic acute myeloid leukaemia (AML) the risk of leukostasis is high due to the rapid increase in WBC count and the size of the myeloid blasts. It is associated with poor prognosis due to an increased risk of early death and relapse. Immediate initiation of cytoreductive treatment is essential to improve outcome, but evidence to prefer hydroxyurea, leukapheresis, intensive chemotherapy (IC) or a combination treatment, is lacking. Therefore, we decided to investigate the current approach of hyperleukocytic AML in Belgium.
A brief questionnaire on the management of hyperleukocytic AML was sent to all Belgian centres currently treating AML with IC and was replied by ten centres. Four centres agreed to a more detailed retrospective analysis. All newly diagnosed AML patients presenting with hyperleukocytosis between January 2013 and April 2019 were included. Patient and disease characteristics were collected, as well as treatment choice and outcome parameters.
We included 121 patients with a median WBC count of 116,360/µL. Mortality at day 21 was 20% and overall mortality was 64% at a median follow-up of six months. Twenty percent received leukapheresis, which was started within 24 hours. There was no difference in age distribution, treatment intensity or time to start IC between patients receiving leukapheresis or not. Although the leukapheresis group had a more severe presentation with a higher median WBC and blast count and a worse performance status, there was no difference in response to therapy, early or long-term mortality. In a multivariate analysis, age at diagnosis and treatment modality (IC vs non-IC) were the only independent parameters that significantly affected early death.
Evidence on optimal treatment options in hyperleukocytic AML is lacking. We could not demonstrate any added value of leukapheresis. To improve the prognosis of this dramatic presentation, national or even European databases should be used to document and learn from the outcome of current practice.
(BELG J HEMATOL 2020;11(7):325-34)
Read moreBJH - volume 11, issue Abstract Book BHS, february 2020
N. Steinfort , M. Metsers , D. Breems MD, PhD, K.L. Wu MD, PhD, P. De schouwer MD, E. Heylen PhD
BJH - volume 6, issue 2, may 2015
S. Meers MD, PhD, D. Breems MD, PhD, G. Bries MD, PhD, M. Delforge MD, PhD, C. Graux MD, PhD, D. Selleslag MD, L. Noens MD, PhD
The guidelines on the current state-of-the-art in the diagnosis and treatment of myelodysplastic syndromes of the Belgian Hematological Society working group on myelodysplastic syndromes were published in 2013.1 The key points of these guidelines are presented in two issues of the Belgian Journal of Hematology. In this paper we present the optimal treatment of patients with myelodysplastic syndromes within the current limitations of Belgian reimbursement modalities.
(BELG J HEMATOL 2015;6(2):54–60)
Read moreBJH - volume 6, issue 1, march 2015
S. Meers MD, PhD, D. Breems MD, PhD, G. Bries MD, PhD, M. Delforge MD, PhD, C. Graux MD, PhD, D. Selleslag MD, L. Noens MD, PhD
The Belgian Hematological Society working group on myelodysplastic syndromes published their guidelines on the state of the art in diagnosis and treatment of myelodysplastic syndromes and the key points of these recommendations are presented in two issues of the Belgian Journal of Hematology.1 In this first paper we present the requirements for a correct diagnosis and classification of patients with myelodysplasia.
(BELG J HEMATOL 2015;6(1):10–5)
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