R. Schots MD, PhD

Practical recommendations for the management of late relapsed and refractory multiple myeloma in 2024

SUMMARY

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)

How is BeQuinT supporting the Belgian hospitals to improve quality in transfusion practice and implement patient blood management?

SUMMARY

The Belgian health authorities created Belgian Quality in Transfusion (BeQuinT) in 2011 to gather experts to improve the quality of transfusion practices in Belgian hospitals. Its mission is also optimising care for patients who might need transfusion through implementation of Patient Blood Management (PBM). Its policy is based on creating and improving financial incentives, developing data-driven and IT-based tools, and providing education and guidance. In this way, BeQuinT attempts to overcome the challenges faced by clinicians and transfusion committees in implementing PBM. In clinical haematology, one of the additional challenges is the need for an individual transfusion approach taking into account the patient’s quality of life and practical aspects of care for chronically transfused patients. In this paper, an overview is presented of the past activities of BeQuinT and PBM implementation challenges followed by a brief focus on PBM in haematology.

(BELG J HEMATOL 2022;13(7):263–8)

18th International Myeloma Workshop 2021

SUMMARY

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 18^th 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)

Highlights in multiple myeloma

SUMMARY

This paper reports on selected oral abstracts presented at ASH 2021 on the treatment of newly diagnosed and relapsed/refractory multiple myeloma (MM) patients.

(BELG J HEMATOL 2022;13(1):5–10)

Guidelines of the Belgian Hematology Society for imaging in multiple myeloma

SUMMARY

Despite major improvements in the diagnosis and treatment of multiple myeloma (MM), bone damage remains a major feature of this disease. With the development of new diagnostic tools, conventional skeletal studies have been progressively replaced by novel imaging techniques. Today, imaging plays a crucial role in defining symptomatic multiple myeloma, measurement of the extent of skeletal involvement and assessing therapeutic response including minimal residual disease (MRD). Based on an extensive review of the recent literature, we propose an array of Belgian recommendations for myeloma imaging to be used as a reference by haematologists in their daily practice.

(BELG J HEMATOL 2021;12(8):338–43)

Caplacizumab, a game changer in the treatment of acquired thrombotic thrombocytopenic purpura

SUMMARY

Acquired or immune-mediated thrombotic thrombocytopenic purpura (aTTP) is a life-threatening auto-immune disorder caused by a functional deficiency of the von Willebrand factor-cleaving protease ADAMTS13, leading to thrombotic microangiopathy. The introduction of plasma-exchange has reduced mortality from over 90% to 10–20%. However, over the last two decades the treatment outcomes have not changed substantially. Caplacizumab, a humanised nanobody directed to the A1 domain of VWF, inhibits this lethal thrombotic cascade and is therefore essential for symptom control and prevention of irreversible end-organ damage. Both TITAN and HERCULES trials demonstrated that treatment with caplacizumab significantly reduced mean duration of hospitalisation and number of days of plasma-exchange. Moreover, no deaths were observed in caplacizumab-treated patients. Therefore, we can state that caplacizumab has changed the treatment paradigm of aTTP.

(BELG J HEMATOL 2020;11(3):120–7)

O.6 Multipotent mesenchymal stromal cells for poor graft function after allogeneic hematopoietic cell transplantation – a multicenter prospective study