BJH - volume 11, issue 7, november 2020
J. Loos MD, M. Beckers MD, PhD, V. Beckers MD, M. Hoyoux MD, prof. dr. W. Peetermans MD, PhD, A. Van De Velde MD, PhD, V. Van Hende MD, A. Vanderfaeillie MD, Y. Van Laethem MD, PhD, A. Janssens MD, PhD
Patients with hematological malignancies suffer from widely varying degrees of immunodeficiency, which leads to an increased susceptibility to a wide range of infections. Some of these, such as influenza and invasive pneumococcal disease, are vaccine preventable. During the Covid19 pandemic these past months patients with hematological malignancies have already shown to be at greater risk of dying, with mortality rates of up to 30% in hospitalized patients.1,2 This has once again highlighted the importance of robust and widely spread vaccination strategies, also we eagerly await an available vaccine for Covid19. In this review, the advisory board on vaccination of the Belgian Hematological Society (BHS), consisting of experts from various disease committees as well as two infectious disease experts attempts to provide clear recommendations regarding vaccinations in patients with hematological malignancies and asplenia. Although transplant recipients share many of the immunodeficiencies of those not transplanted, clear guidelines and vaccination schedules have already been published.3
(BELG J HEMATOL 2020;11(7):305-316)
Read moreBJH - volume 11, issue 3, may 2020
J. Loos MD, D. Dierickx MD, PhD
Oxaliplatin-based chemotherapy is commonly used to treat colorectal cancer. After prolonged administration it can rarely lead to hypersensitivity reactions such as immune mediated haemolytic anaemia and thrombocytopenia. We present the case of a 50-year old patient admitted with acute onset of fever, dark urine and back pain during the ninth infusion of oxaliplatin. Two weeks before the current event he experienced similar though less severe symptoms. Laboratory signs were compatible with severe Coombs positive haemolytic anaemia, thrombocytopenia and acute kidney injury. Signs of haemolysis abated quickly, however, the patient developed anuria and required dialysis for thirty days. Immune mediated haemolytic anaemia is a rare but potentially life-threatening complication of prolonged oxaliplatin therapy, especially when kidney failure develops. A careful history and high index of suspicion may identify warning signs leading to increased vigilance and possible prevention of such events.
(BELG J HEMATOL 2020;11(3):128–32)
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