M. Delforge MD, PhD

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

Myopathy as a rare presentation of AL amyloidosis

SUMMARY

Amyloid myopathy is a rare manifestation of amyloid light chain amyloidosis. We present a case of a 41-year old male with multiple myeloma with muscle hypertrophy, muscle weakness and enlargement of the submandibular glands as the only presenting clinical symptoms, illustrating the sheer difficulty of diagnosing amyloid light chain amyloidosis in patients with mainly soft tissue involvement. Even if there is a clinical suspicion, it is often hard to verify as Congo red stain and immunohistochemistry on muscle biopsy are not always reliable. After bortezomib-based induction treatment followed by autologous stem cell transplantation with high dose melphalan conditioning, he achieved complete haematological remission as well as a significant clinical response. We would like to highlight the importance of early diagnosis and treatment, as progression to more extensive visceral involvement can lead to rapid occurrence of organ failure and death.

(BELG J HEMATOL 2017;8(3):113–7)

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)

O.1 A new frailty scoring in ‘clinically fit’ older patients with malignant hemopathies admitted to receive chemotherapy

Kappa free light chains presenting as an unusual fraction on serum immunofixation electrophoresis

Summary

A 79-year old man presented at the emergency ward of our hospital with symptoms characteristic for multiple myeloma. Although serum capillary zone electrophoresis appeared normal, kappa free light chains were found in serum and in urine by immunofixation electrophoresis. The kappa free light chain fraction detected in the serum, albeit appeared as a polyclonal-like smear with an aberrant localisation in the alpha-2- and beta-regions. Subsequent high resolution gel electrophoresis of the serum suggested the presence of a monoclonal fraction in the alpha-2- and beta-regions, but quantification of the band by densitometry was still not possible. Quantification of free light chains in the patient’s serum by immunonephelometry indicated the presence of an excessive amount of kappa free light chains. However, overestimation of the amount of kappa free light chains by the immunonephelometric method was suspected because of discrepancy with the intensity of the fractions on serum and urine immunofixation electrophoresis.

(BELG J HEMATOL 2016;7(5):194–8)

Highlights in multiple myeloma

Summary

Multiple myeloma (MM) is one of the haematological malignancies with the fastest therapeutic development. Consequently, interesting new data on both preclinical and clinical progress in MM were presented at the 2016 EHA meeting in Copenhagen. We have selected four clinical and one preclinical abstract for discussion in this paper. The choice is based on the importance of the presentations and the impact their results will have on the future treatment landscape in MM.

(BELG J HEMATOL 2016;7(4):130–3)

O.2 RPL5 on 1p22.1 is recurrently deleted in multiple myeloma and its expression is linked to bortezomib response