Articles

Understanding hairy cell leukaemia after analysing the University Hospitals Leuven database retrospectively

BJH - volume 15, issue 6, october 2024

H. Lismont MD, Ir J. Van Ham , A. Janssens MD, PhD

SUMMARY

Hairy cell leukaemia (HCL) is a rare hematologic malignancy with high response rates after purine-analogue based therapy and an excellent long-term prognosis. We reviewed 104 HCL patients diagnosed between 1980 and 2022 at the University Hospitals Leuven to analyse long-term outcomes and complications. Median follow-up was twelve years. In total, 96 patients (92%) received a first-line treatment consisting of splenectomy (n=13), interferon-α (n=13) and cladribine (n=70). This last therapy resulted in the best response rates (overall response (OR) 99%, complete response (CR) 71%) and a long-lasting progression-free-survival (median PFS ten years). Forty-three percent of patients received multiple therapies for subsequent relapses. The median number of treatment lines was one. The median overall survival (OS) was 30.8 years with a 5-year and 10-year OS of approximately 98% and 91%. Although the prognosis of HCL patients is very good, infections and second malignancies are frequently observed. In this cohort, 55% of the patients had a major infection with an infection-related mortality of 3%. After diagnosis, 22% of the HCL patients developed one or more second malignancies, ranging from 1–3 per patient, with a 10-year cumulative risk of 14.5%.

(BELG J HEMATOL 2024;15(6):249–56)

Read more

Straight to the heart

BJH - volume 14, issue 7, november 2023

H. Lismont MD, T. Tousseyn MD, PhD, D. Dierickx MD, PhD

SUMMARY

We report the case of a 56-year-old patient with medical history of acute myeloid leukaemia (AML), presenting with shortness of breath and lower extremity oedema. Transthoracic echocardiogram revealed an important amount of pericardial fluid and an infiltrating mass located at the left ventricular wall. A pericardial window with drainage was performed and a biopsy of the pericardium was taken. The pathological report was compatible with an extramedullary manifestation of AML. Further work-up with complete blood test and bone marrow biopsy confirmed a systemic AML relapse. The patient was treated with re-induction chemotherapy and cardiac radiotherapy followed by a second allogeneic stem cell transplantation, leading to a complete remission.

(BELG J HEMATOL 2023;14(7):304–7)

Read more