BJH - volume 10, issue 2, march 2019
B. Heyrman MD
Alterations in genes involved in cellular metabolism and epigenetic regulation are common in myeloid malignancies. In approximately 20% of acute myeloid leukaemia patients and 5% of patients suffering from myelodysplastic syndromes, recurring mutations in isocitrate dehydrogenase (IDH) are found. Wild-type IDH catalyses the oxidative decarboxylation of isocitrate, thereby contributing to histone demethylation, DNA modification and cellular adaptation to hypoxia. Mutant IDH has neomorphic activity and reduces α-ketoglutarate to 2-hydroxyglutarate. High levels of 2-hydroxyglutarate are associated with hypermethylation, altered gene expression and differentiation block of haematopoietic progenitor cells. There is no prognostic significance of mutant IDH using standard treatment approaches. However, new oral treatments specifically targeting mutant IDH have shown promising results in inducing responses and are well tolerated. Novel combinations with drugs with non-overlapping mechanisms are underway and may address the clonal heterogeneity of myeloid malignancies. For now, only enasidenib and ivosidinib are FDA approved, but the field of mutant IDH inhibitors is rapidly moving.
(BELG J HEMATOL 2019;10(2):80–4)
Read moreBJH - volume 10, issue 2, march 2019
B. Heyrman MD, E. Heylen PhD
A 75-year-old patient presented with fluctuating swelling around the eyes, vasculitis at the lower legs and back of the upper legs and an extreme hypogammaglobulinaemia. An extensive work-up revealed the presence of secondary immunoglobulin M cryoglobulinaemia related to a monoclonal B-cell lymphocytosis. Precipitation of proteins also resulted in a decreased C1-esterase inhibitor causing angioedema. She was treated with an elderly chronic lymphocytic leukaemia regimen consisting of obinutuzumab and chlorambucil with a subsequent clinical and haematological remission.
(BELG J HEMATOL 2019;10(2):85–8)
Read moreBJH - volume 9, issue 4, august 2018
B. Heyrman MD
Novel therapeutic options for patients suffering from myelodysplastic syndromes (MDS) have not managed to climb the stage in recent years. However, clinical trials with new agents were ongoing under the radar. During the 2018 annual EHA meeting, new results were presented that may be inspiring for new clinical trials leading to drug approvals and the expansion of our therapeutic arsenal in this difficult-to-treat patient population. In addition to MDS, this overview will also address the key data on myeloproliferative diseases presented at EHA 2018.
(BELG J HEMATOL 2018;9(4):157–60)
Read moreBJH - volume 7, issue Abstract Book BHS, january 2016
B. Heyrman MD, A. De Becker MD, R. Schots MD, PhD
BJH - volume 6, issue Abstract Book BHS, january 2015
S. Vander Meeren , B. Heyrman MD, W. Renmans , K. Jochmans MD, PhD, M. Bakkus PhD, H. De Raeve MD, PhD, R. Schots MD, PhD, M. De Waele
BJH - volume 6, issue Abstract Book BHS, january 2015
B. Heyrman MD, A. De Becker MD, K. Fostier MD, F. Trullemans , R. Schots MD, PhD
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