H. Schoemans MD, PhD

An unwanted Mediterranean souvenir: Pancytopenia due to visceral leishmaniasis

SUMMARY

We report the case of a 32-year-old female patient who was sent to the emergency department because of nocturnal fever, night sweats, pancytopenia and an elevated CRP. Clinical examination showed a pale patient with a splenomegaly of 17.6 cm. Standard blood tests for infectious diseases remained negative. Travel history revealed a trip to Spain seven months ago. Leishmania serology on blood and polymerase chain reaction (PCR) on bone marrow were found positive. The diagnosis of visceral leishmaniasis was made and the patient was treated with intravenous amphotericin B, with a rapid clinical and biochemical recovery. Leishmaniasis is a (sub)tropical, vector-borne disease caused by intracellular protozoan parasites, spread by sand-flies. Visceral leishmaniasis is the most severe form and presents in a nonspecific way. This case illustrates the importance of a good work-up of pancytopenia, a relatively frequent medical condition with multiple causes. The possibility of visceral leishmaniasis should not be forgotten, especially in case of a suggestive travel history.

(BELG J HEMATOL 2024;15(8):329–32)

Epidemiology of COVID-19 infections in haematology patients and prognostic factors for outcome: A national, multicentre retrospective study

SUMMARY

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)

Acute graft-versus-host disease: diagnosis, pathophysiology and prevention

SUMMARY

Acute graft-versus-host disease (aGVHD) remains a severe complication after allogeneic stem cell transplantation (alloHCT). It is a disregulated immune process, during which the immune cells of the donor attack the healthy tissues in the immunocompromised host. Over the past two decades, progress in understanding its pathophysiology have helped redefine aGVHD reactions and clinical presentations. Typically, the disease presents with serious inflammatory lesions mainly in the skin, gut and liver. Its severity is assessed by gathering clinical signs and dysfunctions of each organ. Despite standard prophylaxis regimens, aGVHD still occurs in approximately 30–60% of transplanted patients and remains a major cause of transplant-related morbidity and mortality. Hence, there is an urgent need for optimising preventive strategies. In this review, we give insights on how to make an accurate diagnosis and scoring assessment of aGVHD, propose a short overview of the current knowledge about its immunobiology and discuss the current and developing strategies for prevention.

(BELG J HEMATOL 2020;11(4):159–173)

P37 Comparison of Multigam^® IV (5% vs. 10%) in hematological patients with secondary immunodeficiencies to evaluate infusion time, tolerability and satisfaction. A monocentric observational Belgian study

O.5 Sequential administration of 5-azacytidine (AZA) and donor lymphocyte infusion (DLI) for patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) in relapse after allogeneic stem cell transplantation (SCT): an interim analysis from the Belgian Hematology Society (BHS)

PP3.3 The ‘EBMT GVHD App’ improves accuracy of graft versus host disease assessment according to NIH criteria compared to standard practice – A proof of concept

P1.12 Tumor lysis syndrome: monocentric evaluation of a predictive tool