BJH - volume 8, issue 3, june 2017
C. Graux MD, PhD
Immunotherapy is an alternative treatment modality for poor conditions associated with chemoresistance like refractory/relapsing primary B-precursor acute lymphoblastic leukaemia or minimal residual disease persistence. The immunotherapeutic effect of allogeneic stem cell transplantation is largely exploited in this context but graft-versus-host disease remains a major concern. Recently, improvements have been made in selectively engaging the immune system against the persistent disease. Blinatumomab is a dual binding antibody construct that redirects any T lymphocytes against B-precursor acute lymphoblastic leukaemia blasts. It shows a very good activity in monotherapy in those poor risk conditions and is associated with a low toxicity profile suggesting this use earlier and in combination in the therapeutic course of B-precursor acute lymphoblastic leukaemia patients. In this article, after a short overview of immunotherapeutic advances in B-precursor acute lymphoblastic leukaemia, the results of the main trials conducted with blinatumomab are discussed and put in perspective.
(BELG J HEMATOL 2017;8(3):107–12)
Read moreBJH - volume 8, issue 2, march 2017
R. Heusschen PhD, J. Muller MSc, N. Withofs MD, PhD, prof. F. Baron , Y. Beguin MD, PhD, J. Caers MD, PhD
Multiple myeloma bone disease is a major cause of morbidity and mortality in multiple myeloma patients and persists even in patients in remission. Multiple myeloma bone disease is caused by an uncoupling of bone remodelling, with increased osteoclast activity and decreased osteoblast activity, culminating in lytic bone destruction. Bisphosphonates are the current standard-of-care but new therapies are needed. As the molecular mechanisms controlling multiple myeloma bone disease are increasingly understood, new therapeutic targets are extensively explored in the preclinical setting and initial clinical trials with novel compounds show promising results. In this review, we provide a comprehensive overview of the biology of multiple myeloma bone disease, summarise its current clinical management and discuss preclinical and clinical data on next generation therapies.
(BELG J HEMATOL 2017;8(2):66–74)
Read moreBJH - volume 7, issue 6, december 2016
S. Servais MD, PhD, C. Grégoire MD, prof. F. Baron , E. Willems MD, PhD, A. Briquet PhD, E. Baudoux MD, O. Delloye PhD, O. Giet PhD, C. Lechanteur PhD, Y. Beguin MD, PhD
Steroid-refractory acute graft-versus-host disease is a severe complication after allogeneic stem cell transplantation. So far, its treatment remains very challenging since the current therapies do not offer significant benefits. Among the most recent approaches, multipotent mesenchymal stromal cell-based therapy has attracted great interest over the past decade. Here, we briefly reviewed the current knowledges about the immunomodulatory properties of multipotent mesenchymal stromal cells as well as results of preclinical and clinical studies having assessed their efficacy to modulate steroid-refractory acute graft-versus-host disease.
(BELG J HEMATOL 2016;7(6):229–35)
Read moreBJH - volume 7, issue 5, october 2016
P. Mineur MD, C. Doyen MD, N. Straetmans MD, PhD, K. Van Eygen MD, D. Pranger MD, A. Bosly MD, PhD, M. André MD, PhD, T. Devos MD, PhD, L. Knoops MD, PhD, On behalf of the MPN Belgian Hematological Society subcommittee
This article describes the Belgian register of chronic myeloid leukaemia patients who have stopped their treatment with imatinib in conditions comparable to the French STIM trial results: 44% remained in major molecular response off therapy; relapses appear rapidly after stopping imatinib and are responsive when the treatment is resumed.
(BELG J HEMATOL 2016;7(5):184–6)
Read moreBJH - volume 7, issue 3, june 2016
I. Moors MD, P. Depuydt MD, PhD, F. Offner MD, PhD, D. Benoit MD, PhD
Outcome of critically ill haematological patients in the intensive care unit has substantially improved during the past decades, with current estimates for intensive care unit survival of 70–75% and one-year survival of 40–45%. Based on new insights, the approach towards critically ill haematological patients is changing, with a focus on early recognition of deteriorating patients in the ward and early referral to the intensive care unit when necessary. Broad admission policies should become the standard, with regular re-assessment of the level of care administered, relative to survival expectations and burden for the patient and family. Close collaboration and communication between attending intensivists and referring haematologists with complementary skills is essential to provide good quality of care, be it either achieving short- and long-term survival and good quality of life, or timely withdrawal of aggressive therapy and institution of appropriate comfort care.
(BELG J HEMATOL 2016; 7(3):112–7)
Read moreBJH - volume 7, issue 2, april 2016
A. Rogiers MD, E. Porcher , D. Dierickx MD, PhD
Thrombotic thrombocytopenic purpura is a non-malignant but life-threatening haematological disorder caused by deficiency of ADAMTS13, a metalloproteinase cleaving ultra-large von Willebrand factor multimer. Urgent initiation of therapeutic plasma exchange, in most cases associated with corticosteroids, has dramatically increased outcome of patients presenting with thrombotic thrombocytopenic purpura. Recently a phase II trial with caplacizumab, a humanised nanobody binding to the A1 domain of von Willebrand factor, has shown promising results by reducing the number of plasma exchanges with an acceptable safety profile.
(BELG J HEMATOL 2016;7(2):79–81)
Read moreBJH - volume 6, issue 5, december 2015
A. Janssens MD, PhD
The first-in-class Bruton’s tyrosine kinase and phosphatidylinositol-3-kinase delta inhibitors have demonstrated impressive clinical activity and tolerability in several B-cell malignancies, both as single agent or in combination with rituximab. As reimbursement of ibrutinib and idelalisib by the Belgian national public health insurance has been granted, this review describes mechanism of action, dosage and administration, efficacy and tolerability. Although both molecules show a very favourable toxicity profile, treating physicians and patients must be aware of some medical events of interest.
(BELG J HEMATOL 2015;6(5):216–24)
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