V. De Wilde MD, PhD

Highlights from the 20^th iwCLL

SUMMARY

The 20^th edition of the international workshop on Chronic Lymphocytic Leukaemia (iwCLL) in Boston showcased significant progress in the management of CLL. In this summary we highlight key findings and emerging insights from the conference.

• Supportive care: infection still represent a significant threat for CLL patients, focusing on prevention remains crucial. Major role for vaccination and immunoglobulins replacement.
• First line treatment: advances in first line CLL treatment have expanded options beyond chemoimmunotherapy. Continuous treatment with covalent BTK inhibitors (cBTKi) as well as fixed-duration treatment such as Obinutuzumab-Venetoclax are effective options for fit and unfit patients.
• Minimal residual disease (MRD): MRD is a strong predictor of prolonged PFS and OS in CLL. However, the relevance of MRD kinetic and its connection to treatment response varies according to the scheme. New techniques considering also the nodal compartment are needed.
• Relapse and emerging therapies: resistance mechanisms and emerging drugs to address double-refractory CLL patients have been explored. New BCL-2 inhibitors, non-covalent BTK inhibitors (ncBTKi) and BTK degraders are the most promising agents. CAR-T cell therapy and bispecific antibodies (BiTEs) also show an interesting preliminary activity in this setting.
• Richter transformation (RT): RT is associated to a wide genetic heterogeneity and poor outcome. New treatments and particularly CAR-T and BiTEs seem promising in this setting.

(BELG J HEMATOL 2023;14(8):347–50)

Epidemiology of COVID-19 infections in haematology patients and prognostic factors for outcome: A national, multicentre retrospective study

SUMMARY

In the early weeks of the ongoing COVID-19 pandemic, little was known about the risk factors of this novel disease in haematology patients. We therefore created a national, multi-center, retrospective study via a national consortium of haematology centres in Belgium to investigate the incidence and clinical characteristics of COVID-19 in haematology patients. By combining these data with data collected through the national public health institute Sciensano and the national Belgian Cancer Registry, we were able to show that haematology patients were at an increased risk of being hospitalised with COVID-19 (1 in 250 haematology patients versus 1 in 2000 in the general population). Furthermore, we found that patients with multiple myeloma and acute leukaemia were overrepresented in these hospitalisations. Mortality at 90 days was 38% during the first wave, compared to 19.3% in the general population. We therefore conclude that haematology patients with COVID-19 are at a significantly higher risk of both hospitalisation and death.

(BELG J HEMATOL 2022;13(7):269–76)

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

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)

The 4th LYSA meeting

SUMMARY

The 4^th edition of the LYSA meeting was organised by Professor Steven Legouill’s team and held in Nantes from the 8^th to 10^th February, 2018. It was a real opportunity for the 500 participants to learn novelties on lymphoma and to be updated on ongoing clinical trials conducted by this cooperative group. All the presentations were outstanding and gave us new indications on how to better treat our patients in the near future.

(BELG J HEMATOL 2017;9(5):195–8)

A Belgian consensus protocol for autologous haematopoietic stem cell transplantation in multiple sclerosis

SUMMARY

Multiple sclerosis is considered to be an immune mediated inflammatory disorder of the central nervous system. It mainly affects young, socioeconomic active patients. Although our armamentarium for this disease has significantly evolved in recent years some patients remain refractory to conventional therapies. In these cases, autologous haematopoietic stem cell transplantation can be considered as a therapeutic option. Decreasing morbidity, mortality and increasing patient awareness have led to rising inquiry by our patients about this treatment option. With the aim of a standardised protocol and data registration, a Belgian working party on stem cell therapy in multiple sclerosis was established. In this paper, we report the consensus protocol of this working party on autologous haematopoietic stem cell transplantation in multiple sclerosis.

(BELG J HEMATOL 2018;9(5):167–74)

PP21 The light chain IgLV3-21 defines a new poor prognostic subgroup in Chronic Lymphocytic Leukemia: results from a multicenter study

P15 Treatment patterns of Waldenström’s macroglobulinemia in Belgium