BJH - volume 12, issue 8, december 2021
N. Meuleman MD, PhD, J. Caers MD, PhD, K. Fostier MD, P. Vlummens MD, S. Pans MD, L. Goethals MD, PhD, J. Alexiou MD, M. Cliquennois MD, C. Doyen MD, A. de Weweire MD, R. Schots MD, PhD, M. Delforge MD, PhD, M.C. Vekemans MD
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)
Read moreBJH - 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
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 moreBJH - volume 12, issue 6, october 2021
C. Schuermans MD, D. Mazure MD, K. Van Eygen MD, L. Van Aelst MD, PhD, S. Benghiat Fleur MD, PhD, T. Devos MD, PhD
Polycythemia vera (PV) is classified by the World Health Organization (WHO) under the BCR-ABL-negative myeloproliferative neoplasms (MPNs) and is characterised by clonal proliferation of myeloid cells, which leads primarily to an increased red blood cell mass. Bone marrow morphology remains the cornerstone of diagnosis. Patients can present with thrombosis, microcirculatory symptoms, haemorrhage, splenomegaly, pruritus and other symptoms that reduce their quality of life and they are at risk of transformation to secondary myelofibrosis (MF) or acute myeloid leukaemia (AML). The main goal of therapy in PV is to minimise the thrombotic risk. To achieve this goal PV patients are being treated with low-dose aspirin and phlebotomies to reach a target haematocrit below 45%. In addition, high-risk patients are being treated with cytoreductive agents. Over the last years, new insights in the pathophysiology, diagnosis and prognosis of polycythemia vera were acquired and novel therapeutic options are available. In this paper we give an update on PV and provide diagnostic and therapeutic recommendations, taking into account the Belgian situation.
(BELG J HEMATOL 2021;12(6):258-74)
Read moreBJH - volume 12, issue 3, may 2021
A. Janssens MD, PhD, D. Selleslag MD, J. Depaus MD, Y. Beguin MD, PhD, C. Lambert MD, PhD
The Belgian Hematology Society (BHS) updated the 2013 guidelines for diagnosis and treatment of primary immune thrombocytopenia (ITP).1 As knowledge about ITP pathophysiology is increasing, the mode of action of old therapies is better understood and novel drugs are introduced to target more specific pathways. Corticosteroids with or without intravenous immunoglobulins (IgIV) remain the first line treatment. According to the updated international guidelines, a short course of corticosteroids rather than a prolonged treatment has to be recommended. The same guidelines stress that consequent therapies as thrombopoietic agents (TPO-RAs) and rituximab should be available independent of duration of ITP. Although the majority of recommendations is based on very low-quality evidence, it is strongly advised to individualise the ITP management taking patient values and preferences in account. The main treatment goal in all ITP patients must be to maintain a safe platelet count to prevent or stop bleeding with a minimum of toxicity and not to normalise the platelet count.
(BELG J HEMATOL 2020;12(3):112-27)
Read moreBJH - 2021, issue 2, march 2021
M. Beckers MD, PhD, S. Sid MD, A. De Becker MD, B. Heyrman MD, N. Granacher MD, D. Mazure MD, S. Meers MD, PhD, M.C. Vekemans MD, On behalf of the other members of MDS and MPN committee
Chronic myelomonocytic leukaemia (CMML) is a rare haematological disease. Hallmark of the diagnosis is chronic monocytosis. Other clinical features include cytopenia, dysplasia with the associated complaints like fatigue or leucocytosis, splenomegaly with constitutional symptoms. Predicting prognosis and choosing the correct treatment can be challenging for the clinician. These guidelines cover the diagnosis and treatment of CMML and provide information on morphology, cytogenetics and molecular testing, clinical features including autoimmune manifestations, prognosis and risk assessment and a treatment algorithm for both the fit and unfit CMML patient.
(BELG J HEMATOL 2020;12(2):66-76)
Read moreBJH - volume 11, issue 8, december 2020
N. Meuleman MD, PhD, M. Vercruyssen MD, M. Cliquennois MD, J. Caers MD, PhD, C. Doyen MD, G. Bries MD, PhD, C. Jacquy MD, PhD, M. Delforge MD, PhD, M.C. Vekemans MD
Immunoglobulin light chain (AL) amyloidosis is a rare and serious disease due to the deposition of amyloid fibrils. In the past years, improvements have been made in the diagnosis, treatment and response criteria. Based on an extensive review of the recent literature on AL amyloidosis, we propose practical recommenddations that can be used by Belgian haematologists as a reference for daily practice. Management of other types of amyloidosis will not be covered by this review. Levels of evidence and grades of recommendations are based on previously published methods.1 We recommend participation in clinical trials to gain knowledge in this evolving field.
(BELG J HEMATOL 2020;11(8):343-56)
Read moreBJH - volume 11, issue 8, december 2020
M.C. Vekemans MD, C. Doyen MD, K.L. Wu MD, PhD, A. Kentos MD, PhD, P. Mineur MD, L. Michaux MD, PhD, J. Caers MD, PhD, N. Meuleman MD, PhD, M. Delforge MD, PhD, On behalf of the BHS Myeloma Subgroup
With the introduction of immunomodulatory drugs, proteasome inhibitors and anti-CD38 monoclonal anti-bodies, major improvements have been achieved in the treatment and outcome of multiple myeloma (MM). Different treatment combinations are now in use and other therapies are being developed. This rapidly changing therapeutic landscape urges for an update on practical guidelines. Based on an extensive review of the recent literature, we propose recommendations on myeloma management, to be used by haematologists as a reference for daily practice.
(BELG J HEMATOL 2020;11(8):357-75)
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