B. De Prijck MD

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)

Update on therapy of relapsed and refractory multiple myeloma

SUMMARY

The prognosis for multiple myeloma patients has improved substantially over the past decade with the development of more effective chemotherapeutic agents and regimens that possess a high level of anti-tumour activity. However, nearly all multiple myeloma patients ultimately relapse, even those who experience a complete response to initial therapy. Management of relapsed disease remains a critical aspect of multiple myeloma care and an important area of ongoing research. This manuscript from the Belgian Haematology Society multiple myeloma subgroup provides some recommendations on the management of relapsed disease.

(BELG J HEMATOL 2017;8(2):53–65)

PP05 The detection rate of PET/CT after co-administration of [18F]NaF and [18F]FDG is superior to the detection rate of whole-body MRI in the diagnosis of MM lesions

BHS Guidelines for the treatment of Burkitt’s lymphoma

Summary

Burkitt’s lymphoma is a rare but very aggressive non-Hodgkin’s lymphoma characterised by an isolated translocation t(8;14)(q24;q32). The sporadic form is the sub-entity most frequently encountered in Belgium. Diagnosis and initial work-up must be completed rapidly to start treatment as soon as possible. Positron emission tomography scan is useful for initial staging and to evaluate the chemosensitivity of the tumour during and after treatment. After debulking, it is recommended to add rituximab to chemotherapy. Currently intensive short-cycle and low intensity chemotherapies are two valuable options. Radiotherapy is not indicated except in case of central nervous system involvement. Patients achieving complete remission must be followed carefully during the first year to detect recurrence of the disease. More than 80% of patients sustain their remission one year following initial treatment and are considered cured. For patients in partial remission or with chemosensitive relapse, autologous stem cell transplantation is recommended following re-induction with non-cross-resistant polychemotherapy. Monitoring complete blood counts and cognitive functions is important to detect late toxicity of the applied therapies.

(BELG J HEMATOL 2015;6(2):61–9)

Haemolytic crisis induced by rasburicase administration revealing G-6-PD deficiency

Summary

We present a patient with Burkitt’s lymphoma who suffered a severe haemolytic crisis after treatment with rasburicase. This case report underlines the high incidence of glucose-6-phosphate dehydrogenase deficiency in some ethnic groups and the importance of a detailed patient and family history before starting treatment, even in case of emergency. Glucose-6-phosphate dehydrogenase is an essential enzyme since it makes the synthesis of NADPH + H from NADP possible, which determines the reducing power (NADPH) of the cell. Every defect in this physiological process, notably glucose-6-phosphate dehydrogenase deficiency, may thus result simultaneously with the use of rasburicase in acute or chronic haemolysis according to the importance of the deficiency. Management is based on stopping the incriminated drug and on supportive therapy consisting of administering packed red blood cells if the anaemia is poorly tolerated.

(BELG J HEMATOL 2015;6(2): 74–8)

P3.05 Long-term safety follow-up of a randomized trial of darbepoetin alpha and intravenous iron following autologous hematopoietic cell transplantation

Update on the initial therapy of multiple myeloma

Summary

With the introduction of immunomodulatory drugs and proteasome inhibitors, major improvements have been achieved in the treatment and prognosis of multiple myeloma. Different treatment combinations are now in use and innovative therapies are being developed. This rapidly changing therapeutic landscape calls for an update on the Belgian myeloma guidelines, published in 2010.¹ Based on an extensive review of the recent literature, the myeloma study group of the Belgian Hematology Society has revised the consensus recommendations on myeloma care, to be used by haematologists as a reference for daily practice. When applicable, comments with regards to the Belgian reimbursement modalities are included. The full text with appendices can be downloaded from the Belgian Hematology Society website (www.bhs.be) and from the Belgium Journal of Hematology website (www.ariez.com).

(BELG J HEMATOL 2014;5(4):125–36)