N. Meuleman MD, PhD

Rational approach of older patients with chronic lymphocytic leukaemia

SUMMARY

The majority of CLL patients are elderly, with a median age of those requiring a first line treatment, close to 76 years old. Nowadays, multiple treatment options are available for this disease, ranging from chemo immunotherapy regimens to biological therapies. The treatment decision in an older CLL patient is a four-step procedure, starting firstly with the assessment of treatment criteria. The second step is to evaluate the life-expectancy of the patient, its autonomy, vulnerabilities and the socio-economic status. The subsequent step is to define treatment options according to prognostic factors. Last, but not least, the patient should be involved in the final decision to know to what extend he is willing to receive a treatment with a potential curative or palliative intent. The assessment of an elderly CLL patient is a complex procedure, not only comprehending the evaluation of biological and hematological parameters but also clinical, social and psychological features, which equally contribute to the selection of the most valuable strategy.

(BELG J HEMATOL 2021;12(4):147-54)

POEMS Syndrome

SUMMARY

Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome is a rare disorder due to an underlying plasma cell clone (PC). The syndrome can affect several organs. The diagnosis is based on the presence of mandatory criteria (polyneuropathy, monoclonal plasma cell disorder) and at least one major and one minor criteria. The therapeutic regimen is determined according to the extent of the patient’s sclerotic lesions and the presence of bone marrow involvement.

(BELG J HEMATOL 2020;11(8):381-6)

Practical management of multiple myeloma: Update 2020

SUMMARY

With the introduction of immunomodulatory drugs, proteasome inhibitors and anti-CD38 monoclonal anti-bodies, major improvements have been achieved in the treatment and outcome of multiple myeloma (MM). Different treatment combinations are now in use and other therapies are being developed. 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 2020;11(8):357-75)

Diagnosis and treatment of AL amyloidosis: Belgian guidelines

SUMMARY

Immunoglobulin light chain (AL) amyloidosis is a rare and serious disease due to the deposition of amyloid fibrils. In the past years, improvements have been made in the diagnosis, treatment and response criteria. Based on an extensive review of the recent literature on AL amyloidosis, we propose practical recommenddations that can be used by Belgian haematologists as a reference for daily practice. Management of other types of amyloidosis will not be covered by this review. Levels of evidence and grades of recommendations are based on previously published methods.¹ We recommend participation in clinical trials to gain knowledge in this evolving field.

(BELG J HEMATOL 2020;11(8):343-56)

Practical management of multiple myeloma: Update 2020

SUMMARY

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 (MM). Different treatment combinations are now in use and other therapies are being developed. 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 2020;11(7):286-304)

P.32 Microcytic anemia: a rare presentation of Waldenström Macroglobulinemia

Adult T-cell leukaemia-lymphoma: Pathogeny and clinical recommendations

SUMMARY

Human T-cell leukaemia virus type 1 (HTLV-1) was the first human oncogenic virus discovered. It is endemic in some regions of the world but increasingly prevalent in our countries as globalisation is progressing. After several decades of asymptomatic carrying, approximately 2–5% of infected individuals will develop adult-T-cell leukaemia-lymphoma (ATL). Despite significant progress in the physiopathology and therapeutic interventions, the prognosis of this rare disease is dismal. An update of classification, clinical features, diagnosis and recent treatment recommendations is outlined in this review.

(BELG J HEMATOL 2019;10(7):277–84)