BJH - volume 4, issue 3, september 2013
F. Van Obbergh MD, A. Van Hoof MD, PhD, G. Verhoef MD, PhD, D. Dierickx MD, PhD, V. De Wilde MD, PhD, F. Offner MD, PhD, D. Bron MD, PhD, A. Sonet MD, M. André MD, PhD, A. Janssens MD, PhD, C. Bonnet MD, B. Deprijck MD, P. Zachée MD, PhD, A. Kentos MD, PhD, W. Schroyens MD, PhD, E. Van den Neste MD, PhD
The sub-committee on lymphoproliferative disorders of the Belgian Hematological Society has met several times to prepare guidelines on the management of patients with peripheral T-cell lymphomas. Each panellist’s expert provided interpretation of the evidence, based on literature review and personal experience. The available evidence was systematically discussed prior to formulating recommendations. A systematic approach to obtain consensus of expert opinion was used. After each meeting, the draft guideline was circulated to all experts for comment and approval. The present guidelines focus on general management of peripheral T-cell lymphomas with special emphasis on more specific disease-adapted strategies.
(BELG J HEMATOL 2013;4(3):90–101)
Read moreBJH - volume 4, issue 2, june 2013
G. Verhoef MD, PhD, W. Schroyens MD, PhD, D. Bron MD, PhD, C. Bonnet MD, V. De Wilde MD, PhD, A. Van Hoof MD, PhD, A. Janssens MD, PhD, D. Dierickx MD, PhD, M. André MD, PhD, E. Van den Neste MD, PhD
The guidelines for adult patients in this article are based on 2011 ESMO and NCCN version 4.2011 guidelines and amended for the particular Belgian context of label prescription and reimbursement. Levels of evidence for the use of treatment recommendations are given in square brackets. Statements without grading were considered justifed standard clinical practice by the experts of the BHS-lymphoma working party.
(BELG J HEMATOL 2013;4(2):51–57)
Read moreBJH - volume 3, issue 4, december 2012
A. Janssens MD, PhD, E. Van den Neste MD, PhD, W. Schroyens MD, PhD, M. André MD, PhD, A. Van Hoof MD, PhD, V. De Wilde MD, PhD, G. Verhoef MD, PhD, F. Offner MD, PhD, D. Bron MD, PhD
Tremendous improvements in treatment outcome have been obtained over the past decade but for most of the patients chronic lymphocytic leukaemia (CLL) still remains an incurable disease. We eagerly await tools incorporating patient related, disease related and treatment related factors, in order to balance efficacy and toxicity and to personalise treatment in a more rational manner. No treatment is necessary for patients without active and/or advanced disease, regardless of prognostic factors. When treatment is indicated we recommend fludarabine, cyclophosphamide, rituximab (FCR) as front-line strategy for fit patients, bendamustine, rituximab (BR) for patients unfit for FCR and chlorambucil for older patients with a geriatric profile or patients with major comorbidities or a reduced performance status. The choice of treatment for patients with recurrent advanced and/ or active disease depends on the duration of response to the previous treatment and on the type of treatment refractoriness. Reduced intensity conditioning allogeneic stem cell transplantation should be considered for patients with a de novo or an acquired 17p deletion, for patients refractory to F, or F and alemtuzumab, or for patients with an early relapse after chemo-immunotherapy.
We encourage patients to enter clinical trials exploring new agents. Among these new approaches, the signal transduction inhibitors have shown remarkable activity in very advanced disease, independent of genetic aberrations.
(BELG J HEMATOL 2012;3: 134–143)
Read moreBJH - volume 3, issue 2, june 2012
S. Debussche MD, A. Van Hoof MD, PhD, A. Sonnet MD, PhD, C. Bonnet MD, A. Janssens MD, PhD, G. Verhoef MD, PhD, D. Dierickx MD, PhD, V. De Wilde MD, PhD, D. Bron MD, PhD, W. Schroyens MD, PhD, E. Van den Neste MD, PhD, F. Offner MD, PhD
Follicular lymphoma is an indolent lymphoma that has occurred more frequently over the last decades. In this article we present an overview of the diagnosis and initial work-up, prognostic scoring system and choice of therapy. For limited stage disease radiotherapy is the treatment of choice, and may have a curative potential. For advanced stages treatment should be initiated upon certain criteria, and is essentially based on immunochemotherapy, rituximab plus chemotherapy. The choice of chemotherapy depends on age, frailty, and specific toxicities of chemotherapy. Maintenance therapy with rituximab after induction has become standard practice. Since virtually all patients relapse eventually, an overview of the treatment in the relapsed setting is given. The treatment is then again based on immunoche-motherapy but there is also a place for radio-immunotherapy, or immunotherapy alone. For young patients, high dose chemotherapy with autologous stem cell rescue should be considered. A brief overview on novel agents, and agents that are in the pipeline, is given. We conclude with some recommendations for follow-up.
(BELG J HEMATOL 2012;3:41–50)
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