Articles

How to treat classical Hodgkin’s lymphoma in older patients: Belgian expert opinion

BJH - volume 12, issue 7, november 2021

S. Snauwaert MD, PhD, V. Van Hende MD, A. Janssens MD, PhD, M. André MD, PhD, S. van Hecke MD, E. Van den Neste MD, PhD, On behalf of the lymphoproliferative disease committee BHS

SUMMARY

Classical Hodgkin’s lymphoma (cHL) is a rather rare disease with an incidence of 2-3/100,000 per year and typically presents in patients at the age of 20–30. It is however well known that a second peak occurs at the age of 60–65 years.1 Nowadays Hodgkin is a curable disease for most of the younger patients but treatment is more difficult and less successful in the older patient population. In this review, we want to summarise the possibilities for the treatment of cHL patients above 60 years, with a focus on evidence from the rather rarely available clinical trials. We also look at future treatments. In this article we will use the term ‘older patients’ for patients of 60 years and older at diagnosis. We will make a distinction between fit patients older than 60 years and frail or vulnerable patients (so called elderly).

(BELG J HEMATOL 2021;12(7):296–304)

Read more

Guidelines of the Belgian Hematological Society for newly diagnosed and relapsed follicular lymphoma anno 2019

BJH - volume 11, issue 2, march 2020

M. Clauwaert MD, V. Galle MD, M. Maerevoet MD, A. Janssens MD, PhD, K. Saevels MD, S. Snauwaert MD, PhD, C. Springael MD, PhD, V. Van Hende MD, G. Verhoef MD, PhD, F. Offner MD, PhD

SUMMARY

Follicular lymphoma is the most common low-grade non-Hodgkin lymphoma. Survival rates have been rising over time mainly due to advancing therapeutic strategies. As the last Belgian guidelines date from 2012, we present an update of the scientific evidence regarding diagnosis, staging, treatment and follow-up, and confront these to the Belgian reimbursement rules anno 2019. Follicular lymphoma grade 3B is classified as high-grade lymphoma and treated accordingly, and will not be discussed in this paper. Early stage disease can be treated with involved-field radiotherapy, which has curative potential. Advanced stage disease is virtually incurable, but many treatment options are available with good results. In first line, treatment is mostly based on chemotherapy combined with rituximab; the latter can be continued as maintenance therapy. In relapsed setting, introduction of the newer and more potent anti-CD20-antibody obinutuzumab, also in combination with chemotherapy, can lead to improved survival in high-risk patients. For older patients with comorbidities, rituximab monotherapy is the preferred option. In further lines, PI3K-inhibition with idelalisib and radioimmunotherapy are available. Finally, autologous or allogeneic stem cell transplantation remain an option in a small group of selected patients.

(BELG J HEMATOL 2020;11(2):67–74)

Read more

BHS guidelines for the treatment of newly diagnosed diffuse large B-cell lymphoma (DLBCL) anno 2020

BJH - volume 11, issue 2, march 2020

G. Swennen MD, A. Janssens MD, PhD, V. Vergote MD, S. Bailly MD, C. Bonnet MD, E. Van den Neste MD, PhD, M. Maerevoet MD, S. Snauwaert MD, PhD, K. Saevels MD, C. Jacquy MD, PhD

SUMMARY

Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma. Prognosis of diffuse large B-cell lymphoma has improved dramatically since the introduction of rituximab and about two thirds of patients can be cured with immunochemotherapy. In the last twenty years, it became clear that diffuse large B-cell lymphoma is a very heterogeneous disease and based on the genetic mutation landscapes numerous efforts have been made to develop novel treatment strategies to improve the prognosis of diffuse large B-cell lymphoma further. This article provides an update of diagnosis, current treatment guidelines and novel treatment strategies for newly diagnosed patients with diffuse large B-cell lymphoma in Belgium. It will also focus on treatment of elderly patients and high-grade B-cell lymphoma.

(BELG J HEMATOL 2020;11(2):56–66)

Read more

P.26 Waldenström’s macroglobulinemia and renal insufficiency: a case report

BJH - volume 11, issue Abstract Book BHS, february 2020

S. Snauwaert MD, PhD, T. Lodewyck MD, P. De Paepe MD, PhD

Read more

Guidelines of the Belgian Hematology Society on the use of stem cell transplantation in lymphoproliferative diseases

BJH - volume 10, issue 2, march 2019

S. Snauwaert MD, PhD, J. Lemmens MD, A. Janssens MD, PhD, T. Kerre MD, PhD

High-dose chemotherapy and autologous or allogeneic haematopoietic stem cell transplantation are widely used in the treatment of lymphoproliferative diseases. For chemo-sensitive relapsed lymphoma (Hodgkin’s and non-Hodgkin’s lymphoma) high-dose chemotherapy and autologous stem cell transplantation are generally accepted as a standard treatment. Emerging data exist for the use of haematopoietic stem cell transplantation in other disease stages for mantle cell lymphoma, follicular lymphoma and some T-cell lymphomas. The use of haematopoietic stem cell transplantation in other conditions is more controversial and remains a clinical option for selected patients or experimental within the framework of a clinical trial.

(BELG J HEMATOL 2019;10(2):69–79)

Read more

Hodgkin’s lymphoma: Belgian Hematology Society guidelines in diagnosis, treatment and follow-up

BJH - volume 9, issue 6, november 2018

V. Van Hende MD, G. Verhoef MD, PhD, S. Snauwaert MD, PhD, V. De Wilde MD, PhD, B. De Prijck MD, A. Janssens MD, PhD, M. André MD, PhD

SUMMARY

Hodgkin’s lymphoma (HL) is a rare B cell malignant neoplasm affecting approximately 300 new patients in Belgium annually. This disease represents approximately 11% of all lymphomas and comprises two discrete disease entities: classical HL and nodular lymphocyte-predominant HL. In recent years, treatment of HL patients has changed tremendously due to the use of interim PET-CT scan and the appearance of new molecules. In this article, the diagnosis, staging, treatment and long-term follow-up of patients with classical HL are discussed.

(BELG J HEMATOL 2018;9(6):214–24)

Read more

P33 Use of Ibrutinib for Chronic Lymphocytic Leukemia (CLL) in Routine Clinical Practice: Results from the Belgian Ibrutinib Real-World Data (BiRD) Study

BJH - 2018, issue Abstract Book BHS, february 2018

A. Janssens MD, PhD, S. Snauwaert MD, PhD, R. Wapenaar , C. Van Bogaert , A. Smet , V. Seynhaeve

Read more