BJH - volume 15, issue 6, october 2024
N. Kint MD, PhD, M.C. Vekemans MD, N. Meuleman MD, PhD, J. Caers MD, PhD, C. Doyen MD, J. Depaus MD, R. Callens MD, G. Claes MD, C. Jacquy MD, PhD, A. Kentos MD, PhD, H. Maes MD, F. Offner MD, PhD, A. Salembier MD, R. Schots MD, PhD, K. Theunissen MD, I. Vande Broek MD, PhD, A. Van De Velde MD, PhD, K.L. Wu MD, PhD, M. Delforge MD, PhD
Despite significant advances in therapeutic modalities, the treatment of relapsed and refractory multiple myeloma (RRMM) is still challenging. In this publication, we aim to provide an update on therapeutic modalities for RRMM in Belgium. First, novel combinations of well-established therapeutic agents will be discussed. Second, T-cell redirection therapies will be addressed. These include bispecific antibodies, both anti-BCMA x CD3 and anti-GPRC5D x CD3, as well as chimeric antigen receptor (CAR) T cell therapy. Third, we discuss novel modalities such as antibody-drug conjugates, selinexor, venetoclax, melflufen and CELMoDs. Finally, a general flowchart regarding overall treatment sequencing will be proposed, providing an integrated treatment recommendation from frontline to relapse.
(BELG J HEMATOL 2024;15(6):225–32)
Read moreBJH - volume 15, issue 4, june 2024
M.C. Vekemans MD, N. Kint MD, PhD, G. Claes MD, C. Doyen MD, V. Galle MD, C. Jacquy MD, PhD, H. Maes MD, N. Meuleman MD, PhD, O. Rizzo MD, A. Salembier MD, H. Schots MD, PhD, G. Verstraete MD, M. Delforge MD, PhD
Despite the increasing availability of more effective treatments for newly diagnosed multiple myeloma (NDMM) patients that provide longer disease-free periods, almost all patients will experience a relapse. Managing relapse after regimens that have included a proteasome inhibitor (PI), an immunomodulatory drug (IMID), and often an anti-CD38 monoclonal antibody can be challenging, but therapeutic options have greatly increased over the past decades. This review covers the current second-line therapeutic options and provides updated information on novel agents for the treatment of early relapses in MM patients.
(BELG J HEMATOL 2024;15(4):158–64)
Read moreBJH - volume 15, issue 3, may 2024
M.C. Vekemans MD, N. Meuleman MD, PhD, N. Kint MD, PhD, G. Claes MD, C. Doyen MD, V. Galle MD, C. Jacquy MD, PhD, H. Maes MD, O. Rizzo MD, A. Salembier MD, H. Schots MD, PhD, G. Verstraete MD, M. Delforge MD, PhD
With the introduction of immunomodulatory drugs, proteasome inhibitors and anti-CD38 monoclonal antibodies, major improvements have been achieved in the treatment and outcome of multiple myeloma. Different treatment combinations are now in use and quadruplets have been investigated with success. This rapidly changing therapeutic landscape urges for an update on practical guidelines. Based on an extensive review of the recent literature, we propose recommendations on myeloma management, to be used by haematologists as a reference for daily practice.
(BELG J HEMATOL 2024;15(3):103–16)
Read moreBJH - volume 13, issue 7, november 2022
N. Kint MD, PhD, M. Delforge MD, PhD
Plasma cell leukaemia (PCL) is a rare and aggressive plasma cell malignancy and is generally considered to be the final stage of multiple myeloma (MM). Although treatment modalities for MM have significantly evolved in the past decades, PCL unfortunately still retains an overall dismal prognosis, with most patients presenting with a highly symptomatic and aggressive disease course. We present a case of a transplant-ineligible patient diagnosed with a primary PCL who had an indolent presentation and achieved a durable complete remission after treatment via bortezomib-lenalidomide-dexamethasone (VRD). The present case illustrates the clinical heterogeneity of plasma cell disorders, and highlights the necessity of careful cytomorphological and flow cytometric analysis of aberrant lymphoid cells, even in the absence of stigmata of MM.
(BELG J HEMATOL 2022;13(7):277–80)
Read moreBJH - volume 13, issue 2, march 2022
N. Kint MD, PhD, W. De Brouwer MD, R. Schots MD, PhD
The diagnostic and therapeutic landscape of multiple myeloma (MM) has been in constant evolution, resulting in many novel treatment opportunities for patients with MM, though many challenges remain in providing optimal care for patients with MM. In this article, several recent updates with regard to the diagnosis and treatment of MM, as presented at the 18th International Myeloma Workshop (IMW), have been summarised. In this summary, two main topics have been highlighted: 1) early treatment of high-risk smouldering MM, in combination with the development of non-invasive methods for risk stratification of smouldering MM, using circulating tumour cells and 2) updates on trials regarding novel treatment modalities, including novel combination regimens in newly diagnosed and relapsed MM patients, as well as novel immune therapies, with a focus on CAR-T cell therapy and bispecific antibodies.
(BELG J HEMATOL 2022;13(2):95–9)
Read moreBJH - volume 10, issue 8, december 2019
S. Vlayen MSc, N. Kint MD, PhD, M. Delforge MD, PhD
As the surface antigen CD38 is highly expressed on malignant plasma cells, it provides an interesting therapeutic target for the treatment of multiple myeloma (MM). At present, three anti-CD38 monoclonal antibodies (mAb) have been studied in MM: daratumumab, isatuximab and MOR202. All three anti-CD38 mAb show complement-dependent cytotoxicity (CDC), antibody-dependent cellular cytotoxicity (ADCC) and antibodydependent cellular phagocytosis (ADCP) activities. Moreover, immunomodulatory effects of daratumumab and isatuximab have been demonstrated. At present, daratumumab has been the most extensively studied anti-CD38 mAb in clinical trials. Following the excellent results of phase III clinical trials in relapsed/refractory MM (RRMM), daratumumab has recently also been studied in phase III clinical trials in newly diagnosed patients. The effects of isatuximab and MOR202 have been studied in phase III and phase I clinical trials, respectively, in patients with RRMM.
(BELG J HEMATOL 2019;10(8):326–31)
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