BJH - volume 14, issue 2, march 2023
I. Moors MD, D. Deeren , C. Jacquy MD, PhD, A. Jaspers MD, PhD, T. Kerre MD, PhD, V. Havelange MD, PhD, D. Selleslag MD, C. Spilleboudt MD, N. Straetmans MD, PhD, F. Van Obbergh MD, A. De Voeght MD, S. Anguille MD, PhD, A. Schauwvlieghe MD, PhD, N. De Beule MD, PhD, A. De Becker MD, D. Breems MD, PhD
Acute myeloid leukaemia is an aggressive form of bone marrow cancer with poor prognosis, especially in elderly, unfit patients. The VIALE-A study showed an impressive improvement in complete remission rate and overall survival with the addition of venetoclax, a BCL-2 inhibitor, to azacitidine. This combination therapy is now reimbursed in Belgium for newly diagnosed adult AML patients who are considered unfit for intensive chemotherapy based on age and/or comorbidities. In this article, we provide recommendations on the use of this new combination, as well as on prophylaxis and management of specific side effects.
(BELG J HEMATOL 2023;14(2):59–66)Read more
BJH - volume 13, issue 7, november 2022
T. Mercier MD, PhD, S. Fieuws PhD, K. Theunissen MD, M-C. Ngirabacu MD, PhD, N. Straetmans MD, PhD, C. Spilleboudt MD, D. Mazure MD, V. De Wilde MD, PhD, A. De Becker MD, D. Selleslag MD, D. Breems MD, PhD, D. Deeren , S. Servais MD, PhD, C. Jacquy MD, PhD, H. Poirel MD, PhD, D. Van Beckhoven MD, K. Blot MD, PhD, A. Janssens MD, PhD, H. Schoemans MD, PhD
In the early weeks of the ongoing COVID-19 pandemic, little was known about the risk factors of this novel disease in haematology patients. We therefore created a national, multi-center, retrospective study via a national consortium of haematology centres in Belgium to investigate the incidence and clinical characteristics of COVID-19 in haematology patients. By combining these data with data collected through the national public health institute Sciensano and the national Belgian Cancer Registry, we were able to show that haematology patients were at an increased risk of being hospitalised with COVID-19 (1 in 250 haematology patients versus 1 in 2000 in the general population). Furthermore, we found that patients with multiple myeloma and acute leukaemia were overrepresented in these hospitalisations. Mortality at 90 days was 38% during the first wave, compared to 19.3% in the general population. We therefore conclude that haematology patients with COVID-19 are at a significantly higher risk of both hospitalisation and death.
(BELG J HEMATOL 2022;13(7):269–76)Read more
BJH - volume 13, issue 1, february 2022
A. De Becker MD
Allogeneic haematopoietic cell transplantation (alloHCT) is a complex procedure that involves many different factors: patient characteristics, disease characteristics, donor choice, stem cell source, choice of conditioning regimen, graft versus host disease (GvHD) prevention and treatment, prevention and treatment of disease relapse and management of (non-)infectious complications. This paper discusses some key studies that were presented regarding patient characteristics, donor choice, GvHD prophylaxis and treatment and treatment of disease relapse after alloHCT. Now two years into the pandemic, it is impossible to ignore SARS-CoV-2, seroconversion after mRNA vaccination of alloHCT recipients in France will be discussed.
(BELG J HEMATOL 2022;13(1):43-7)Read more
BJH - 2021, issue 2, march 2021
M. Beckers MD, PhD, S. Sid MD, A. De Becker MD, B. Heyrman MD, N. Granacher MD, D. Mazure MD, S. Meers MD, PhD, M-C. Vekemans MD, PhD, On behalf of the other members of MDS and MPN committee
Chronic myelomonocytic leukaemia (CMML) is a rare haematological disease. Hallmark of the diagnosis is chronic monocytosis. Other clinical features include cytopenia, dysplasia with the associated complaints like fatigue or leucocytosis, splenomegaly with constitutional symptoms. Predicting prognosis and choosing the correct treatment can be challenging for the clinician. These guidelines cover the diagnosis and treatment of CMML and provide information on morphology, cytogenetics and molecular testing, clinical features including autoimmune manifestations, prognosis and risk assessment and a treatment algorithm for both the fit and unfit CMML patient.
(BELG J HEMATOL 2020;12(2):66-76)Read more
BJH - volume 11, issue 3, may 2020
N. De Beule MD, PhD, R. Schots MD, PhD, A. De Becker MD
Acquired or immune-mediated thrombotic thrombocytopenic purpura (aTTP) is a life-threatening auto-immune disorder caused by a functional deficiency of the von Willebrand factor-cleaving protease ADAMTS13, leading to thrombotic microangiopathy. The introduction of plasma-exchange has reduced mortality from over 90% to 10–20%. However, over the last two decades the treatment outcomes have not changed substantially. Caplacizumab, a humanised nanobody directed to the A1 domain of VWF, inhibits this lethal thrombotic cascade and is therefore essential for symptom control and prevention of irreversible end-organ damage. Both TITAN and HERCULES trials demonstrated that treatment with caplacizumab significantly reduced mean duration of hospitalisation and number of days of plasma-exchange. Moreover, no deaths were observed in caplacizumab-treated patients. Therefore, we can state that caplacizumab has changed the treatment paradigm of aTTP.
(BELG J HEMATOL 2020;11(3):120–7)Read more
BJH - volume 11, issue Abstract Book BHS, february 2020
S. Servais MD, PhD, prof. F. Baron , C. Lechanteur PhD, E. Baudoux MD, A. Briquet PhD, D. Selleslag MD, J. Maertens MD, PhD, X. Poiré MD, PhD, W. Schroyens MD, PhD, C. Graux MD, PhD, A. De Becker MD, R. Schots MD, PhD, P. Zachée MD, PhD, A. Ory , J. Herman , T. Kerre MD, PhD, Y. Beguin MD, PhD
BJH - volume 11, issue 1, february 2020
A. De Becker MD
This article will summarise the key studies in the field of acute leukaemia presented at the 2019 annual meeting of the American Society of Hematology (ASH). The selected abstracts in the field of acute myeloid leukaemia (AML) mainly focus on precision medicine, measurable residual disease (MRD) and maintenance treatment. In addition, results of the phase I trial using CD19/CD22 bispecific CAR T cells in paediatric and adult patients with acute lymphoblastic leukaemia (ALL) will be discussed.
(BELG J HEMATOL 2020;11(1):18–20)Read more