BJH - volume 14, issue 4, june 2023
U. Douven MD, A. Janssens MD, PhD, G. Crochet MD, S. Bailly MD, C. Bonnet MD, C. Jacquy MD, PhD, F. Offner MD, PhD, S. Snauwaert MD, PhD, E. Van den Neste MD, PhD, M. Vercruyssen MD, D. Dierickx MD, PhD, P. Vandenberghe MD, PhD, V. Vergote MD
Approximately 30–40% of patients with diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS), will relapse or are unable to obtain a complete remission (CR) after frontline treatment. These patients have a poor prognosis and represent a therapeutic challenge. In this article, we reviewed the recent literature to update the practice guidelines of the Belgian Hematology Society (BHS) Lymphoproliferative Disease Committee for the treatment of relapsed or refractory (R/R) DLBCL. In the first part, we will focus on first relapse and the role of CAR T-cell therapy in first and second relapse. In the second part, we will focus on novel treatment options for patients with a second or higher relapse, secondary central nervous system (CNS) relapse and high-grade lymphoma.
(BELG J HEMATOL 2023;14(4):170–7)
Read moreBJH - volume 14, issue 3, may 2023
U. Douven MD, A. Janssens MD, PhD, G. Crochet MD, S. Bailly MD, C. Bonnet MD, C. Jacquy MD, PhD, F. Offner MD, PhD, S. Snauwaert MD, PhD, E. Van den Neste MD, PhD, M. Vercruyssen MD, D. Dierickx MD, PhD, P. Vandenberghe MD, PhD, V. Vergote MD
Approximately 30–40% of patients with diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS), will relapse or are unable to obtain a complete remission (CR) after frontline treatment. These patients have a poor prognosis and represent a therapeutic challenge. In this article, we reviewed the recent literature to update the practice guidelines of the Belgian Hematology Society (BHS) Lymphoproliferative Disease Committee for the treatment of relapsed or refractory (R/R) DLBCL. In the first part, we will focus on first relapse and the role of CAR T-cell therapy in first and second relapse. In the second part, we will focus on novel treatment options for patients with a second or higher relapse, secondary central nervous system (CNS) relapse and high-grade lymphoma.
(BELG J HEMATOL 2023;14(3):114–21)
Read moreBJH - volume 13, issue 2, march 2022
B. Sciot MD, T. Devos MD, PhD, T. Tousseyn MD, PhD, N. Boeckx MD, PhD, L. Michaux MD, PhD, P. Vandenberghe MD, PhD
Introduction: Advanced systemic mastocytosis is a rare myeloproliferative disorder of mast cells, damaging the function of various organs and tissues. The diagnosis can be challenging due to its protean manifestations and rareness. Treatment options have improved over the last years. Currently, avapritinib, a novel tyrosine kinase inhibitor with activity against p.D816V mutated KIT, is under investigation.
Case: We report a case of a 64-year old man with chronic diarrhoea, fatigue, weight loss and ascites with hepatomegaly, developing an upper gastro-intestinal bleeding with multiple duodenal ulcers. Diagnostic work-up revealed hepatosplenomegaly and portal hypertension, a vertebral compression fracture and multiple 18F-FDG avid supra- and infradiaphragmatic lymph nodes and bone marrow. Based on the 2016 WHO criteria of systemic mastocytosis, and a concomitant chronic myelomonocytic leukaemia, the diagnosis of an aggressive systemic mastocytosis with an associated haematological neoplasm was made. The patient was consecutively treated with midostaurin, cladribine and avapritinib, the latter inducing a complete biochemical and molecular response.
Conclusion: This case illustrates the challenging clinical presentation of systemic mastocytosis. A deep response to avapritinib was observed despite prior use of midostaurin and cladribine, underlining its promise in advanced systemic mastocytosis.
(BELG J HEMATOL 2022;13(2):84–91)
Read moreBJH - 2021, issue 2, march 2021
P. Beuselinck MD, Ir J. Van Ham , N. Boeckx MD, PhD, T. Devos MD, PhD, P. Vandenberghe MD, PhD, G. Verhoef MD, PhD
BACKGROUND: Tyrosine kinase inhibitors (TKIs) have improved the survival of patients with chronic myeloid leukaemia (CML). TKIs can be successfully discontinued in some CML patients who have achieved a stable deep molecular response.
OBJECTIVE: The purpose of this article is twofold. On the one hand, this review provides an overview of current use and discontinuation of TKIs in patients with CML. On the other hand, we retrospectively investigated the use and possible discontinuation of TKIs in a specific patient population with CML at the University Hospital of Leuven.
METHODS: A literature search was carried out in May 2019 to identify all relevant articles. Articles were searched on PubMed, Embase, Web of Science and Cochrane Library. Additionally, the articles found in the reference list were used.
RESULTS: This review included ten articles (two on imatinib, four on dasatinib, four on nilotinib), with 970 patients. Treatment free remission (TFR) ratio varied from 41–68% after one year. One study published the results of TFR after three years. In UZ Leuven, the TFR ratio was 60% after 106 weeks.
CONCLUSION: Tyrosine kinase inhibitor (TKI) therapy can be safely terminated in selected patient groups. About half of the patients retain the molecular remission after discontinuation of TKI therapy.
(BELG J HEMATOL 2020;12(2):52-8)
Read moreBJH - volume 10, issue 8, december 2019
T. Feys MBA, MSc, G. Roex , Y. Beguin MD, PhD, T. Kerre MD, PhD, X. Poiré MD, PhD, P. Lewalle MD, PhD, P. Vandenberghe MD, PhD, D. Bron MD, PhD, S. Anguille MD, PhD
Chimeric antigen receptor (CAR) T-cell therapy is a new cancer immunotherapy targeting specific cell surface antigens. This type of adoptive cell immunotherapy has been a breakthrough in the treatment of aggressive B-cell lymphoma and B-cell precursor acute lymphoblastic leukaemia (ALL) and is currently also being studied in other cancer types, including multiple myeloma and chronic lymphocytic leukaemia. This review will discuss the recent clinical developments and future perspectives of CAR T-cell therapy, with a focus on the clinical trials that led to the FDA and EMA approval of tisagenlecleucel (Kymriah®, Novartis) and axicabtagene ciloleucel (Yescarta®, Gilead) for the treatment of childhood/adult relapsed/refractory (r/r) B-cell precursor ALL and aggressive B-cell non-Hodgkin lymphoma.
(BELG J HEMATOL 2019;10(8):301–10)
Read moreBJH - volume 10, issue 6, october 2019
E. Van Valckenborgh PhD, M. Bakkus PhD, E. Boone PhD, A. Camboni MD, PhD, J-P. Defour PhD, B. Denys MD, H. Devos MD, L. Dewispelaere MD, G. Froyen PhD, A. Hébrant PhD, P. Heimann MD, PhD, P. Hermans MD, PhD, E. Heylen PhD, K. Jacobs PhD, F. Lambert MD, M. Le Mercier Apr, PhD, E. Lierman PhD, H. Louagie MD, PhD, B. Maes MD, PhD, M-B. Maes PhD, G. Martens MD, PhD, L. Michaux MD, PhD, F. Nollet PhD, MSc, H.A. Poirel MD, PhD, G. Raicevic PhD, P. Saussoy MD, PhD, T. Tousseyn MD, PhD, M. Van Den Bulcke PhD, P. Vandenberghe MD, PhD, K. Vandepoele PhD, P. Vannuffel PhD, T. Venken PhD, K. Vermeulen PhD
Molecular diagnostics have an increasing impact on diagnosis, risk stratification and targeted treatment in haemato-oncology. In the framework of a pilot study for the implementation of next-generation sequencing in the Belgian healthcare system, the Commission of Personalised Medicine was founded to give professional and evidence-based advice on the molecular analysis in haemato-oncology. This paper describes its recommendations for NGS analysis in myeloid malignancies. In addition, the minimally required set of genes that must be analysed is defined and algorithms for molecular workflow in myeloid malignancies are proposed.
(BELG J HEMATOL 2019;10(6):241–9)
Read moreBJH - volume 10, issue 6, october 2019
P. Vandenberghe MD, PhD
Editorial for the contribution of E. Van Valckenborgh et al., entitled: Diagnostic testing in myeloid malignancies by next-generation sequencing: recommendations from the Commission Personalised Medicine (BELG J HEMATOL 2019;10(6):241–9)
(BELG J HEMATOL 2019;10(6):229–30)
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