F. Offner MD, PhD

P36 Can CLL-IPI at time of diagnosis predict who may never need treatment for B-CLL?

P45 Donor cell derived deletion 7q occurring after allogeneic stem cell transplantation: a case report

P14 The impact of the updated IMWG diagnostic criteria in a real-life SMM cohort: a single center experience

P17 Diagnostic strength of bone marrow aspirate versus biopsy in (smoldering) multiple myeloma patients

Improving care for critically ill haematological patients in the ICU: a modern perspective

Summary

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)

Updated BHS guidelines for the treatment of chronic lymphocytic leukaemia anno 2016

summary

The Belgian Hematological Society Lymphoproliferative Working Party updated the 2012 recommendations on the best strategies for front-line and subsequent-line treatment of small lymphocytic leukaemia/chronic lymphocytic leukaemia. No treatment is necessary for patients without active and/or advanced disease, regardless of prognostic factors. When front-line treatment is indicated we recommend adding an anti-CD20 monoclonal antibody to chemotherapy except in frail patients: fludarabine, cyclophosphamide, rituximab for fit patients; bendamustine, rituximab for fit patients >65 years or unfit for fludarabine, cyclophosphamide, rituximab; and chlorambucil with obinutuzumab or rituximab for older patients with a geriatric profile, major comorbidities or a reduced performance status. The choice of treatment for patients with recurrent disease depends on the duration of response to the previous treatment, the type of treatment refractoriness and the presence of a 17p deletion/p53 mutation. As an alternative, chemoimmunotherapy can be proposed for patients with a late relapse. The novel B-cell receptor inhibitors are the best choice for those relapsing early, who have refractory disease or are unfit for chemoimmunotherapy. The B-cell receptor inhibitors are also first choice for each patient with a de novo or acquired 17p deletion/p53 mutation. Reduced intensity conditioning allogeneic stem cell transplantation should still be considered for patients with high-risk disease after response induction by the B-cell receptor inhibitors. We still have to encourage patients to enter clinical trials exploring new drug combinations.

(BELG J HEMATOL 2015;6(5): 195–202)

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)