BJH - volume 9, issue 7, december 2018
O. Stas , E. Mourin MD, J. Depaus MD, F-X. Hanin , I. Theate , M. André MD, PhD
We report the case of a 69-year-old woman who presented an aggressive breast implant-associated anaplastic large cell lymphoma with supra- and infradiaphragmatic disease. The diagnosis was made 17 years after her first prosthesis, following a right breast carcinoma, and three years after the replacement of this first prosthesis. Breast implant-associated anaplastic large cell lymphoma is a rare form of non-Hodgkin lymphoma caused by a breast implant. Unique features of this case include the fast clinical extension of a lymphoma that is indolent in the vast majority of the cases. Indeed, less than two months after the first symptoms on the breast, cutaneous metastasis appeared on the right arm. The key diagnosis exams are histology and immunohistochemistry including CD30 and cytotoxic markers and a PET-scan to evaluate the extension of the disease. The treatment should include removal of the prosthesis and any associated mass. Local residual or unresectable disease may benefit from radiation therapy to the chest wall. For regional lymph node involvement or confirmed extended disease, adjuvant chemotherapy more in line with systemic anaplastic large cell lymphoma anaplastic lymphoma kinase-negative treatments is recommended. Finally, brentuximab vedotin, an anti-CD30 monoclonal antibody, showed encouraging results in refractory disease but still needs more prospective trials.
(BELG J HEMATOL 2018;9(7):279–84)
Read moreBJH - 2018, issue Abstract Book BHS, february 2018
O. Stas , E. Mourin MD, J. Depaus MD, F-X. Hanin , I. Theate , M. André MD, PhD
BJH - volume 6, issue 5, december 2015
V. Vergote MD, A. Janssens MD, PhD, E. Van den Neste MD, PhD, G. Verhoef MD, PhD, E. Mourin MD, M. André MD, PhD, A. Van Hoof MD, PhD
Mantle cell lymphoma is a rare B-cell non-Hodgkin’s lymphoma characterised by a t(11;14) translocation resulting in overexpression of cyclin D1 and cell cycle dysregulation. Mantle cell lymphoma represents approximately 7–9% of all lymphomas in Europe.1 Although new treatment regimens have improved the outcomes over the last decades, mantle cell lymphoma is still considered one of the worst prognosis B-cell non-Hodgkin’s lymphoma with a median overall survival of less than five years.2 In September 2014 the Belgian Hematological Society recommendations for the treatment of mantle cell lymphoma were published.3 Since then, novel therapies such as ibrutinib and bortezomib have been approved by the European Medicines Agency in the treatment of mantle cell lymphoma. We present the new updated recommendations of the Belgian Hematological Society Lymphoproliferative Working Party. For young patients, the first line therapy remains an AraC-containing chemo-immunotherapy followed by high dose chemotherapy and autologous stem cell transplantation. For the main group of elderly patients, chemo-immunotherapy followed by maintenance with rituximab appears to be the gold standard. In relapse we can recommend treatment with BTK-inhibitor ibrutinib as first choice. Temsirolimus is reimbursed as third line treatment. Relapse patients should also be considered for allogeneic stem cell transplantation if eligible.
(BELG J HEMATOL 2015;6(5):203–8)
Read moreBJH - volume 5, issue 3, september 2014
E. Mourin MD, A. Van Hoof MD, PhD, A. Bosly MD, PhD, C. Bonnet MD, V. De Wilde MD, PhD, C. Doyen MD, C. Hermans MD, PhD, A. Janssens MD, PhD, L. Michaux MD, PhD, W. Schroyens MD, PhD, A. Sonet MD, E. Van den Neste MD, PhD, G. Verhoef MD, PhD, P. Zachée MD, PhD, M. André MD, PhD
Mantle cell lymphoma was recognised in the nineties and is characterised by the t(11;14)(q13;q32) translocation which results in overexpression of cyclin D1.1 This disease represents approximately 6% of all non-Hodgkin’s lymphomas. Mantle cell lymphoma generally affects patients over 60 years-old. Most patients have advanced disease (>70 % Ann Arbor stage IV). Several efforts have been made to predict outcome in mantle cell lymphoma. The cell-proliferation marker Ki-67, the Mantle Cell Lymphoma International Prognostic Index, fluorodeoxyglucose positron emission tomography and minimal residual disease are prognostic tools. For young patients, chemoimmunotherapy followed by high-dose chemotherapy plus stem cell transplantation is the treatment of choice. For the main group of older patients, chemo-immunotherapy followed by maintenance with rituximab is the gold standard. In relapses, temsirolimus is actually registered and new drugs, such as ibrutinib, are currently evaluated with promising preliminary results.2–5
(BELG J HEMATOL 2014;5(3):89–96)
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