BJH - volume 9, issue 5, september 2018
V. Liberton MD, R. Colman , G. Laureys MD, PhD, V. Bordon MD, PhD, C. Dhooge MD, PhD
Adult patients with high serum ferritin have an increased risk of organ toxicity and iron chelation before stem cell transplant might be an option. We report our experience in 58 paediatric patients (excluding patients with haemoglobinopathy and hyper-transfused patients) undergoing allogeneic stem cell transplant between 2007 and 2012. Serum ferritin pre-transplant was highly variable (mean: 932 µg/L) and related to a number of PRC transfusions. Eighteen of 58 patients had ferritin level >1000 µg/L before transplant. Eight patients suffered from transplant-related mortality. We found no correlation between transplant-related mortality and pre-transplant serum ferritin (p=0.67). Seven patients developed veno-occlusive disease, reversible in all cases. We did not find a correlation between serum ferritin and veno-occlusive disease, graft-versus-host disease or relapse. The evolution of ferritin post-transplant shows a spontaneous lowering of ferritin in the first two years after haematopoietic stem cell transplantation to normal range. An association between serum ferritin and elevated AST/ALT at 12 and 24 months was noted and follow-up concerning possible liver damage in patients with a persistently high serum ferritin is recommended. This study concludes that high serum ferritin has no influence on transplant-related mortality in children, chronically poly-transfused patients excluded. Although chelation is already used in paediatric HSCT, there is insufficient, current evidence to do so.
(BELG J HEMATOL 2018;9(5):182–7)
Read moreBJH - volume 8, issue 2, march 2017
A-S. De Koninck PharmD, C. Dhooge MD, PhD, B. Denys PharmD, K. Vandepoele PhD, N. Van Roy PhD, M. Hofmans MD, J. Philippé MD, PhD
We describe a case of a four-year-old boy diagnosed with an Early T-cell Precursor Lymphoblastic Leukaemia. This type of leukaemia is recognised as a high-risk subgroup characterised by very early arrest in T-cell differentiation. Early T-cell Precursor Lymphoblastic Leukaemia cases have characteristic gene expression profiles, increased genomic instability and a distinct immature immunophenotype (CD1a–, CD8–, CD5+dim and positivity for at least one marker of stem cell or myeloid lineage). This type of leukaemia is associated with poor prognosis and a poor response to intensive chemotherapy, though this finding is still debated. Our patient displayed an inferior response to induction therapy. The main purpose of this report is to make Belgian physicians aware of this entity and its controversial prognostic significance.
(BELG J HEMATOL 2017;8(2):75–9)
Read moreBJH - volume 7, issue Abstract Book BHS, january 2016
V. Bordon MD, PhD, C. Dhooge MD, PhD, E. Claerebout , S. Casaert , G. Laureys MD, PhD
BJH - 2013, issue BHS Abstractbook, january 2013
V. Bordon MD, PhD, P. Verloo , S. Verbeek , C. Dhooge MD, PhD
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