BJH - volume 5, issue 3, september 2014
E. Mourin MD, A. Van Hoof MD, PhD, A. Bosly MD, PhD, C. Bonnet MD, PhD, V. De Wilde MD, PhD, C. Doyen MD, PhD, C. Hermans MD, PhD, A. Janssens MD, PhD, L. Michaux MD, PhD, W. Schroyens MD, PhD, A. Sonet MD, E. Van den Neste MD, PhD, G. Verhoef MD, PhD, P. Zachée MD, PhD, M. André MD
Mantle cell lymphoma was recognised in the nineties and is characterised by the t(11;14)(q13;q32) translocation which results in overexpression of cyclin D1.1 This disease represents approximately 6% of all non-Hodgkin’s lymphomas. Mantle cell lymphoma generally affects patients over 60 years-old. Most patients have advanced disease (>70 % Ann Arbor stage IV). Several efforts have been made to predict outcome in mantle cell lymphoma. The cell-proliferation marker Ki-67, the Mantle Cell Lymphoma International Prognostic Index, fluorodeoxyglucose positron emission tomography and minimal residual disease are prognostic tools. For young patients, chemoimmunotherapy followed by high-dose chemotherapy plus stem cell transplantation is the treatment of choice. For the main group of older patients, chemo-immunotherapy followed by maintenance with rituximab is the gold standard. In relapses, temsirolimus is actually registered and new drugs, such as ibrutinib, are currently evaluated with promising preliminary results.2–5
(BELG J HEMATOL 2014;5(3):89–96)
Read moreBJH - volume 5, issue 2, june 2014
I. Moors MD, H. Schoemans MD, PhD, S. Callens MD, PhD, Y. Beguin MD, PhD, T. Kerre MD, PhD
Haematopoietic stem cell transplantation is increasingly used as consolidation therapy in severe haematological diseases. In the post-transplantation period, the immunity of haematopoietic stem cell transplantation recipients is impaired due to toxicity of the pre-haematopoietic stem cell transplantation treatment (chemo- and/or radiotherapy), the conditioning regimen with a reset of the immune system, and – in case of allogeneic haematopoietic stem cell transplantation – the use of immunosuppressive drugs and potentially graft-versus-host-disease. This leads to a considerably increased risk of infections, with high morbidity and mortality. Therefore, prevention of infections, i.a. by revaccination, is of major importance to improve outcomes. We present the Belgian guidelines for vaccination after haematopoietic stem cell transplantation, based on available data in the literature and international guidelines, taking into account the availability of vaccines and – if applicable – their reimbursement in Belgium. We describe a general vaccination schedule for post-haematopoietic stem cell transplantation patients, indications for pre-transplant vaccination and donor vaccination and an overview of special indications, such as travel vaccinations, vaccinations of close contacts and health care workers, with recommendations for titer follow-up.
(BELG J HEMATOL 2014;5(2):44–54)
Read moreBJH - volume 5, issue 1, march 2014
D. Bron MD, PhD, E. Van den Neste MD, PhD, A. Kentos MD, F. Offner MD, PhD, W. Schroyens MD, PhD, C. Bonnet MD, PhD, A. Van Hoof MD, PhD, G. Verhoef MD, PhD, A. Janssens MD, PhD
Marginal zone lymphomas are a heterogeneous subtype of indolent B-non-Hodgkin Lymphoma that includes three distinct diseases: Extranodal mucosa associated lymphoid tissue lymphoma, nodal marginal zone lymphoma and splenic marginal zone lymphoma lymphocytes +/− villous lymphocytes. The different diagnosis, work up and treatment options are discussed in these guidelines.
(BELG J HEMATOL 2014;5(1):12–21)
Read moreBJH - volume 4, issue 4, december 2013
T. Devos MD, PhD, N. Straetmans MD, PhD, C. Schuermans MD, S. Benghiat MD, PhD, V. Robin MD, P. Lewalle MD, PhD, P. Mineur MD, G. Verhoef MD, PhD, L. Knoops MD, PhD
Diagnostic and management guidelines for myelofibrosis patients are presented in this paper. As a consequence of the rapid evolution and progress in this domain over the last years, the need was felt by the BHS MPN subcommittee to update these guidelines for our country. The different prognostic scores in myelofibrosis, the diagnostic tools and treatment options with the focus on new possibilities are discussed.
(BELG J HEMATOL 2013;4(4): 127–137)
Read moreBJH - volume 4, issue 3, september 2013
F. Van Obbergh MD, A. Van Hoof MD, PhD, G. Verhoef MD, PhD, D. Dierickx MD, PhD, V. De Wilde MD, PhD, F. Offner MD, PhD, D. Bron MD, PhD, A. Sonet MD, M. André MD, A. Janssens MD, PhD, C. Bonnet MD, PhD, B. Deprijck MD, P. Zachée MD, PhD, A. Kentos MD, W. Schroyens MD, PhD, E. Van den Neste MD, PhD
The sub-committee on lymphoproliferative disorders of the Belgian Hematological Society has met several times to prepare guidelines on the management of patients with peripheral T-cell lymphomas. Each panellist’s expert provided interpretation of the evidence, based on literature review and personal experience. The available evidence was systematically discussed prior to formulating recommendations. A systematic approach to obtain consensus of expert opinion was used. After each meeting, the draft guideline was circulated to all experts for comment and approval. The present guidelines focus on general management of peripheral T-cell lymphomas with special emphasis on more specific disease-adapted strategies.
(BELG J HEMATOL 2013;4(3):90–101)
Read moreBJH - volume 4, issue 2, june 2013
G. Verhoef MD, PhD, W. Schroyens MD, PhD, D. Bron MD, PhD, C. Bonnet MD, PhD, V. De Wilde MD, PhD, A. Van Hoof MD, PhD, A. Janssens MD, PhD, D. Dierickx MD, PhD, M. André MD, E. Van den Neste MD, PhD
The guidelines for adult patients in this article are based on 2011 ESMO and NCCN version 4.2011 guidelines and amended for the particular Belgian context of label prescription and reimbursement. Levels of evidence for the use of treatment recommendations are given in square brackets. Statements without grading were considered justifed standard clinical practice by the experts of the BHS-lymphoma working party.
(BELG J HEMATOL 2013;4(2):51–57)
Read moreBJH - volume 4, issue 1, march 2013
A. Janssens MD, PhD, C. Lambert MD, G. Bries MD, PhD, A. Bosly MD, PhD, D. Selleslag MD, Y. Beguin MD, PhD
The Belgian Hematological Society (BHS) guideline panel on adult primary immune thrombocytopenia (ITP) reviewed the recent literature on diagnosis and treatment to make recommendations on the best strategies for frontline and subsequent-line treatment. No treatment is necessary for patients with platelet counts higher than 30000/μl in the absence of bleeding symptoms. Patients newly diagnosed or relapsing after a long-term treatment-free period can be managed with corticosteroids with or without intravenous immunoglobulins. A second line therapy is indicated for those patients who are intolerant or unresponsive to or relapse after initial corticosteroid treatment and have a risk of bleeding. The guideline panel recommends splenectomy as it is the treatment with the highest curative potential and an acceptable safety profile. If possible, splenectomy should be delayed to at least twelve months after diagnosis as spontaneous remission can occur in this time period. Thrombopoietin receptor (TPO-R) agonists are recommended for patients who are refractory to or relapse after splenectomy or who have a contra-indication to splenectomy irrespective of the duration of ITP. The guideline panel agrees that rituximab, azathioprine, cyclophosphamide, cyclosporine A, danazol, dapsone, mycophenolate mofetil and vincristine/vinblastine are potential treatment options, especially for patients refractory to TPO-R agonists.
(BELG J HEMATOL 2013;1:11–20)
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