C. Bonnet MD, PhD

BHS Guidelines for the treatment of Burkitt’s lymphoma

Summary

Burkitt’s lymphoma is a rare but very aggressive non-Hodgkin’s lymphoma characterised by an isolated translocation t(8;14)(q24;q32). The sporadic form is the sub-entity most frequently encountered in Belgium. Diagnosis and initial work-up must be completed rapidly to start treatment as soon as possible. Positron emission tomography scan is useful for initial staging and to evaluate the chemosensitivity of the tumour during and after treatment. After debulking, it is recommended to add rituximab to chemotherapy. Currently intensive short-cycle and low intensity chemotherapies are two valuable options. Radiotherapy is not indicated except in case of central nervous system involvement. Patients achieving complete remission must be followed carefully during the first year to detect recurrence of the disease. More than 80% of patients sustain their remission one year following initial treatment and are considered cured. For patients in partial remission or with chemosensitive relapse, autologous stem cell transplantation is recommended following re-induction with non-cross-resistant polychemotherapy. Monitoring complete blood counts and cognitive functions is important to detect late toxicity of the applied therapies.

(BELG J HEMATOL 2015;6(2):61–9)

Haemolytic crisis induced by rasburicase administration revealing G-6-PD deficiency

Summary

We present a patient with Burkitt’s lymphoma who suffered a severe haemolytic crisis after treatment with rasburicase. This case report underlines the high incidence of glucose-6-phosphate dehydrogenase deficiency in some ethnic groups and the importance of a detailed patient and family history before starting treatment, even in case of emergency. Glucose-6-phosphate dehydrogenase is an essential enzyme since it makes the synthesis of NADPH + H from NADP possible, which determines the reducing power (NADPH) of the cell. Every defect in this physiological process, notably glucose-6-phosphate dehydrogenase deficiency, may thus result simultaneously with the use of rasburicase in acute or chronic haemolysis according to the importance of the deficiency. Management is based on stopping the incriminated drug and on supportive therapy consisting of administering packed red blood cells if the anaemia is poorly tolerated.

(BELG J HEMATOL 2015;6(2): 74–8)

P1.08 Multiparameter flow cytometric analysis of composite lymphoma: case report of a mantle cell lymphoma associated with a B-cell chronic lymphocytic leukemia and an aberrant T cell subset

P3.05 Long-term safety follow-up of a randomized trial of darbepoetin alpha and intravenous iron following autologous hematopoietic cell transplantation

Treatment of mantle cell lymphomas: recommendations of the Belgian Hematological Society

Summary

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)

BHS guidelines for the treatment of marginal zone lymphomas

Summary

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)

P1.08 Hemolytic crisis induced by rasburicase administration revealing G-6-PD deficiency