K.L. Wu MD, PhD

P.38 Five in a row – a cascade of hematological malignancies: a case report

Practical management of newly-diagnosed multiple myeloma: 2018 update for transplant eligible patients

With the introduction of immunomodulatory agents and proteasome inhibitors, major improvements have been achieved in the treatment and outcome of multiple myeloma. Different treatment combinations are now in use and newer therapies are being developed. Nevertheless, autologous stem cell transplantation remains the corner stone of therapy for fit, newly-diagnosed multiple myeloma patients. Based on an extensive review of the recent literature, we propose recommendations on myeloma care, to be used by haematologists as a reference for daily practice.

(BELG J HEMATOL 2019;10(3):113–21)

Practical management of newly-diagnosed multiple myeloma: 2018 update for transplant eligible patients

SUMMARY

With the introduction of immunomodulatory agents (IMiDs) and proteasome inhibitors (PIs), major improvements have been achieved in the treatment and outcome of multiple myeloma (MM). Different treatment combinations are now in use and newer therapies are being developed. Nevertheless, autologous stem cell transplantation (ASCT) remains the corner stone of therapy for fit, newly-diagnosed MM patients. Based on an extensive review of the recent literature, we propose recommendations on myeloma care, to be used by haematologists as a reference for daily practice.

Ixazomib: the first oral proteasome inhibitor for the treatment of multiple myeloma

SUMMARY

The ubiquitin-proteasome system is a major pathway for the degradation of most intracellular proteins and therefore plays an essential regulatory role in cellular processes including cell cycle progression, proliferation, differentiation and apoptosis. The recognition of its importance in tumorigenesis has led to the development of agents that target this pathway as cancer therapeutics. Bortezomib is the first proteasome inhibitor approved for clinical use and has a profound impact on the survival of patients with multiple myeloma. Ixazomib is a promising second generation proteasome inhibitor.

(BELG J HEMATOL 2017;8(6):229–31)

BHS guidelines for the diagnosis and the treatment of hairy cell leukaemia

SUMMARY

Hairy cell leukaemia is a rare chronic B-cell lymphoproliferative disorder characterised by a long natural course with, in most of cases, an excellent response to a single course of purine analogue monochemotherapy. Making the right diagnosis, excluding the chemo resistant variant form of hairy cell leukaemia, and making progresses in the treatment of relapsing and/or refractory disease remains challenging up to date. In recent years, exciting results with new agents are emerging and clinical trials are ongoing to optimize the management of hairy cell leukaemia and its variant form.

(BELG J HEMATOL 2017;8(6):222–8)

Update on therapy of relapsed and refractory multiple myeloma

SUMMARY

The prognosis for multiple myeloma patients has improved substantially over the past decade with the development of more effective chemotherapeutic agents and regimens that possess a high level of anti-tumour activity. However, nearly all multiple myeloma patients ultimately relapse, even those who experience a complete response to initial therapy. Management of relapsed disease remains a critical aspect of multiple myeloma care and an important area of ongoing research. This manuscript from the Belgian Haematology Society multiple myeloma subgroup provides some recommendations on the management of relapsed disease.

(BELG J HEMATOL 2017;8(2):53–65)

BHS guidelines for the treatment of large granular lymphocyte and chronic prolymphocytic leukaemias

Summary

Large granular lymphocyte and prolymphocytic leukaemias are rare chronic lymphoproliferative disorders. Large granular lymphocyte leukaemias consist of indolent disorders such as T-cell large granular lymphocyte and chronic lymphoproliferative disorder of natural killer cells and the very rare but aggressive natural killer cell leukaemia. Treatment of the indolent large granular lymphocyte leukaemias is necessary in case of symptomatic cytopaenias or non-haematological autoimmune disorders. First line therapy of these two disorders is based on three immunosuppressive drugs: methotrexate, cyclophosphamide and cyclosporine A. Aggressive natural killer cell leukaemia needs an L-asparaginase containing regimen as induction followed by allogeneic stem cell transplantation to prolong remission. T-cell prolymphocytic leukaemia always follows an aggressive course even after an indolent onset. The optimal treatment strategy should exist of remission induction with alemtuzumab intravenously followed by autologous or allogeneic stem cell transplantation. Treatment indications for B-cell prolymphocytic leukaemia follow the criteria described by the chronic lymphocytic leukaemia guidelines. After induction with fludarabine, cyclophosphamide, rituximab or bendamustine in patients without a p53 mutation and/or a 17p deletion and alemtuzumab in case of a p53 mutation and/or a 17p deletion, stem cell transplantation must be considered.

(BELG J HEMATOL 2016; 7(3):103–11)