A. Kentos MD, PhD

Paraprotein-related peripheral neuropathy

SUMMARY

Monoclonal gammopathy of undetermined significance (MGUS) is quite frequent in the general population. The association between MGUS and peripheral neuropathy (PN) was described in various studies demonstrating a higher than expected prevalence of PN in patients with MGUS. The demonstration of causality remains a diagnostic challenge as a coincidental association may also occur. Specific diagnostic criteria are available for only a few disorders: DADS, POEMS, amyloidosis, cryoglobulinemia. Data to guide management are quite limited. We present a short review of the literature and emphasise the need of a close collaboration between haematologists and neurologists for an optimal management.

(BELG J HEMATOL 2021;12(6):251-7)

Practical management of multiple myeloma: Update 2020

SUMMARY

With the introduction of immunomodulatory drugs, proteasome inhibitors and anti-CD38 monoclonal anti-bodies, major improvements have been achieved in the treatment and outcome of multiple myeloma (MM). Different treatment combinations are now in use and other therapies are being developed. This rapidly changing therapeutic landscape urges for an update on practical guidelines. Based on an extensive review of the recent literature, we propose recommendations on myeloma management, to be used by haematologists as a reference for daily practice.

(BELG J HEMATOL 2020;11(8):357-75)

Practical management of multiple myeloma: Update 2020

SUMMARY

With the introduction of immunomodulatory drugs, proteasome inhibitors and anti-CD38 monoclonal antibodies, major improvements have been achieved in the treatment and outcome of multiple myeloma (MM). Different treatment combinations are now in use and other therapies are being developed. This rapidly changing therapeutic landscape urges for an update on practical guidelines. Based on an extensive review of the recent literature, we propose recommendations on myeloma management, to be used by haematologists as a reference for daily practice.

(BELG J HEMATOL 2020;11(7):286-304)

Practical management of newly-diagnosed multiple myeloma: 2018 update for transplant eligible patients

With the introduction of immunomodulatory agents and proteasome inhibitors, major improvements have been achieved in the treatment and outcome of multiple myeloma. Different treatment combinations are now in use and newer therapies are being developed. Nevertheless, autologous stem cell transplantation remains the corner stone of therapy for fit, newly-diagnosed multiple myeloma patients. Based on an extensive review of the recent literature, we propose recommendations on myeloma care, to be used by haematologists as a reference for daily practice.

(BELG J HEMATOL 2019;10(3):113–21)

Practical management of newly-diagnosed multiple myeloma: 2018 update for transplant eligible patients

SUMMARY

With the introduction of immunomodulatory agents (IMiDs) and proteasome inhibitors (PIs), major improvements have been achieved in the treatment and outcome of multiple myeloma (MM). Different treatment combinations are now in use and newer therapies are being developed. Nevertheless, autologous stem cell transplantation (ASCT) remains the corner stone of therapy for fit, newly-diagnosed MM patients. Based on an extensive review of the recent literature, we propose recommendations on myeloma care, to be used by haematologists as a reference for daily practice.

Update on therapy of relapsed and refractory multiple myeloma

SUMMARY

The prognosis for multiple myeloma patients has improved substantially over the past decade with the development of more effective chemotherapeutic agents and regimens that possess a high level of anti-tumour activity. However, nearly all multiple myeloma patients ultimately relapse, even those who experience a complete response to initial therapy. Management of relapsed disease remains a critical aspect of multiple myeloma care and an important area of ongoing research. This manuscript from the Belgian Haematology Society multiple myeloma subgroup provides some recommendations on the management of relapsed disease.

(BELG J HEMATOL 2017;8(2):53–65)

Diagnosis and treatment of AL Amyloidosis in 2015: Consensus guidelines of the Belgian Hematological Society

Summary

Immunoglobulin light chain amyloidosis is a clonal plasma cell dyscrasia, historically associated with a very poor prognosis. Prompt diagnosis is critical to preserve organ function and improve survival in immunoglobulin light chain amyloidosis patients. The severity of cardiac involvement and response to treatment are the most important prognostic factors. Serum free light chain ratio and cardiac biomarkers troponin T and N-terminal pro-brain natriuretic peptide are powerful tools for the evaluation of prognosis and treatment response. Historically, treatment with autologous stem cell transplantation appears to offer a survival benefit, but is only an option in a minority of patients. IMiDs, and especially proteasome inhibitors, have shown promising activity in immunoglobulin light chain amyloidosis. Supportive care should be integrated in the treatment plan and requires a multidisciplinary approach. These guidelines summarise a consensus of the myeloma subcommittee of the Belgian Hematological Society on diagnosis, cytoreductive and supportive treatment of immunoglobulin light chain amyloidosis, based on an extended review of the literature. Where applicable, comments were added with respect to the Belgian reimbursement modalities.

(BELG J HEMATOL 2015;6(5):187–94)