G. Verhoef MD, PhD

Cell of origin in diffuse large B-cell lymphoma: the way to targeted therapy?

SUMMARY

Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma type worldwide, but the treatment still remains challenging because only 60–70% of the patients can be cured with the standard immunochemotherapy (rituximab, cyclophosphamide-doxorubicin-vincristine-prednisone) scheme. In the last twenty years, several molecular-genetic studies showed that DLBCL comprises at least two distinct molecular subtypes: the activated B-cell-like and the germinal centre B-cell-like subtype. The two groups have different genetic mutation landscapes and outcomes following treatment, with the ABC subtype having the worst prognosis. Gene expression profiling seems to be the gold standard method to subdivide DLBCL into ABC and GCB subtypes, but it is difficult to include this technology in clinical practice because it relies on fresh frozen tissue and microarray technology. To facilitate the DLBCL classification in daily clinical practice, other technologies have been developed allowing analysis of formalin-fixed paraffine embedded tissue biopsies. The unique genetic and epigenetic features of both DLBCL subtypes make targeted therapy a promising approach in the future.

(BELG J HEMATOL 2018;9(6):206–13)

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)

Whole-body diffusion-weighted magnetic resonance imaging for staging and early treatment response assessment in malignant lymphoma

SUMMARY

Diffusion-weighted magnetic resonance imaging (DW/MRI) is a radiation-free functional imaging technique reflecting tissue cellularity by probing the diffusion of water molecules on a microstructural level. This can be assessed visually, but also quantified by calculating the apparent diffusion coefficient (ADC). Although established in many solid tumours and multiple myeloma, its role in disease assessment in malignant lymphoma has yet to be determined. Therefore, the main purpose of this work was twofold: exploring the performance of whole-body DW/MRI (WB-DW/MRI) in staging malignant lymphoma and assessing treatment response early during treatment with 18F-FDG-PET/CT in combination with bone marrow biopsy results serving as the gold standard. Regarding staging, we found that WB-DW/MRI is a feasible imaging technique. Visual image analysis sufficed to accurately detect extranodal disease, while adequate nodal characterisation required ADC calculations. Lymph node characterisation was further improved by using a more elaborate quantitative analysis based on ADC parameters derived from whole-lesion ADC histogram analysis next to the commonly used mean ADC. In the context of treatment response assessment, mean ADC changes between the baseline and interval scan performed after one cycle of (immuno)chemotherapy significantly correlated with progression-free-survival in patients with aggressive non-Hodgkin lymphoma (NHL). For Hodgkin lymphoma, taking into account the typical intralesional heterogeneity, an advanced 3-D texture analysis was performed, which demonstrated that ADC parameters associated with tumour heterogeneity (energy, local homogeneity, and entropy) were predictive of outcome in contrast to conventional ADC parameters.

(BELG J HEMATOL 2018;9(6):242–4)

O3 Polycythemia vera and hydroxyurea resistance/intolerance: a monocentric retrospective analysis

PP02 Monocentric retrospective study of 138 therapy-related myeloid neoplasms

PP38 Autologous hematopoietic stem-cell transplantation in lymphoma – a single center experience

BHS guidelines for the diagnosis and the treatment of hairy cell leukaemia

SUMMARY

Hairy cell leukaemia is a rare chronic B-cell lymphoproliferative disorder characterised by a long natural course with, in most of cases, an excellent response to a single course of purine analogue monochemotherapy. Making the right diagnosis, excluding the chemo resistant variant form of hairy cell leukaemia, and making progresses in the treatment of relapsing and/or refractory disease remains challenging up to date. In recent years, exciting results with new agents are emerging and clinical trials are ongoing to optimize the management of hairy cell leukaemia and its variant form.

(BELG J HEMATOL 2017;8(6):222–8)