BJH - volume 6, issue 5, december 2015
D.A. Breems MD, PhD, B. Löwenberg MD, PhD
Relapse is the most prevalent cause of treatment failure and death in patients with acute myeloid leukaemia. Because only a minority of patients who experience relapse will derive durable benefit from current reinduction and salvage therapy, prognostic factors and predictive models have been developed. Achievement of a second complete remission and the application of salvage allogeneic stem cell transplantation represent crucial objectives for reaching long-term disease-free survival and improving the prognosis of patients with acute myeloid leukaemia in first relapse. Combination chemotherapy schedules that include high-dose cytarabine are frequently used in therapeutic efforts of attaining a second complete remission. In relapsed acute myeloid leukaemia with poor risk genetic features or those with early relapse after previous exposure to high-dose cytarabine, investigational drugs may be the preferred choice. The search for improved treatment with novel agents in clinical trials represents an active area of research.
(BELG J HEMATOL 2015;6(5):182–7)
Read moreBJH - volume 6, issue 4, october 2015
O. Ketelslegers MD, F. Eyskens MD, PhD, F. Boemer PhD, V. Bours MD, PhD, J-M. Minon MD, PhD, B. Gulbis MD, PhD
Although neonatal screening for sickle cell disease is one of the best tools for reducing mortality during infancy and early childhood, it is not part of the approved neonatal screening programme in Belgium. As epidemiological data on sickle cell disease are still incomplete in Belgium, we planned to screen the samples of newborns available in the biggest reference centre for approved neonatal screening in Flanders. From July to December 2013, a total of 18,989 newborns from 36 Flemish maternity wards were systematically screened, representing about 60% of the total number of births in Flanders. For the same period, results of the neonatal screening that is routinely performed for sickle cell disease in three other Belgian centres were collected. Overall, 39,599 newborns were screened, representing about two-thirds of Belgian births for this period. With an incidence of sickle cell disease and sickle cell trait of 1/2,329 and 1/77, respectively, sickle cell disease is the most frequently inherited disease observed in the population tested; the highest incidences were registered in urban areas. In addition, screening techniques identified 122 other clinically significant haemoglobin (Hb) variant carriers (83 for HbC, twenty for HbE, thirteen for HbD-Punjab, and six for HbO-Arab) and two HbC diseases. Carriers of clinically significant Hb variants were observed in almost all the maternity wards included in the study, showing a wide dispersal of populations at risk. These epidemiological data remind us of the warnings and recommendations from the World Health Organization, urging policy-makers to consider the most appropriate strategy to prevent and treat patients with sickle cell disease in Belgium.
(BELG J HEMATOL 2015;6(4): 135–41)
Read moreBJH - volume 6, issue 2, may 2015
M. Oyaert MSc, M. Delforge MD, PhD, N. Boeckx MD, PhD
Flow cytometric immunophenotyping is recommended for diagnosis, classification and monitoring of disease in monoclonal gammopathies. Furthermore, it is a useful diagnostic tool for clinical practice and has various applications, such as its ability to distinguish between normal, reactive and malignant plasma cells, to evaluate the risk of progression from monoclonal gammopathy of undetermined significance to plasma cell myeloma, to provide prognostic information, to evaluate the presence of minimal residual disease and to identify new therapeutic targets. The incorporation of novel therapies in the management of patients diagnosed with plasma cell neoplasms has increased depth and frequency of response, as well as prolonged progression free and overall survival. Along with these improvements in therapeutic strategies, definition of responses to treatment has evolved over time. It was therefore necessary to develop reproducible and sensitive assays for detection and monitoring of minimal residual disease and to define its prognostic value in predicting progression free and overall survival, to allow for consolidation and maintenance therapeutic strategies and to evaluate the efficacy of novel therapies.
(BELG J HEMATOL 2015;6(2):46–53)
Read moreBJH - volume 6, issue 1, march 2015
M. Maerevoet MD, J. Vouriot MD, N. Meuleman MD, PhD, D. Bron MD, PhD
Diffuse large B-cell lymphoma is a frequent pathology in older individuals, and though curable by R-CHOP 21, treatment toxicity increases in frail patients. Therefore, therapeutic choices have to take into account Comprehensive Geriatric Assessment in addition to Performance Status, but reliable and standardised clinical decision-making tools are sorely lacking. However, Mabthera-containing treatments adapted for frail patients and co-morbidities can be used with a satisfactory survival rate at two years. Nevertheless, the main cause of death remains disease progression.
(BELG J HEMATOL 2014;6(1):4–9)
Read moreBJH - volume 5, issue 4, december 2014
H. Helsmoortel PhD, T. Lammens PhD, N. Van Roy PhD, J. Philippé MD, PhD, P. De Paepe MD, PhD, Y Benoit MD, PhD, F. Speleman PhD, P. Van Vlierberghe PhD, B. De Moerloose MD, PhD
Juvenile myelomonocytic leukaemia is a very rare, aggressive stem cell disorder predominantly affecting infants and young children. Current survival rates are disappointing and the only available curative therapy is haematopoietic stem cell transplantation. Over the last years, intensive research efforts elucidated a plethora of molecular aberrations involved in the pathogenesis of juvenile myelomonocytic leukaemia. Current investigations are mainly directed towards the complete unravelling of the molecular biology behind the disease in order to find more specific drugs. This review will focus on the diagnosis, genomic characterisation and the use of experimental therapies in juvenile myelomonocytic leukaemia.
(BELG J HEMATOL 2014; 5(4): 119–24)
Read moreBJH - volume 5, issue 3, september 2014
J. Van Der Straeten MSc, B. De Moerloose MD, PhD, M-F. Dresse MD, PhD, S. Dupont MD, A. Ferster MD, PhD, P. Philippet MD, A. Uyttebroeck MD, PhD, J. van der Werff ten Bosch MD, PhD, C. Demanet MD, PhD, Y Benoit MD, PhD, M. Bakkus PhD
In Belgium approximately 70 children are diagnosed with acute lymphoblastic leukaemia annually. For these children, the monitoring of minimal residual disease has an important prognostic value. The level of minimal residual disease during the first three months of therapy is used to recognise subgroups that differ substantially in outcome. Two techniques are used for minimal residual disease monitoring: the Genescan method and the allele specific oligonucleotide polymerase chain reaction. The Genescan method is a less sensitive method (10−3) but is fast and less expensive. The allele specific oligonucleotide polymerase chain reaction requires more time and budget but has a sensitivity of 10−4–10−5. Both techniques have proven their value in minimal residual disease monitoring in childhood acute lymphoblastic leukaemia.
(BELG J HEMATOL 2014;5(3):81–8)
Read moreBJH - volume 5, issue 2, june 2014
J. Van Meirhaeghe MD
Balloon kyphoplasty is a minimally invasive procedure for the treatment of painful vertebral compression fractures due to primary or secondary osteoporosis, osteolytic lesions due to myeloma or bone metastasis, or trauma. Balloon kyphoplasty aims to reduce and stabilise the fracture, thereby providing immediate and sustained pain relief, improved physical function and better quality of life. Balloon kyphoplasty differs from vertebroplasty in that it is also designed to restore diminished vertebral height and correct kyphotic deformity.
(BELG J HEMATOL 2014;5(2):36–43)
Read more
Top
