A. Wolfromm MD, S. Bailly MD, E. Van den Neste MD, PhD, M. André MD, PhD, K. Saevels MD, H. Antoine-Poirel MD, PhD, T. Tousseyn MD, PhD, V. Van Hende MD, S. Snauwaert MD, PhD, A. Janssens MD, PhD, C. Jacquy MD, C. Bonnet MD, PhD
SUMMARY
Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive diseases associated with poor outcomes. Recent progress in understanding of the biology and pathogenesis based on molecular profiling and next-generation sequencing has led to the introduction of new provisional entities in the World Health Organization (WHO) classification system of 2017 and to the emergence of new drugs.1 Previous Belgian guidelines were published in 2013.2 This review will discuss the diagnosis, work-up and treatment of PTCL including these advances as well as the limitation of the availability of drugs according to the Belgian reimbursement rules.
S. Snauwaert MD, PhD, V. Van Hende MD, A. Janssens MD, PhD, M. André MD, PhD, S. van Hecke MD, E. Van den Neste MD, PhD, On behalf of the lymphoproliferative disease committee BHS
SUMMARY
Classical Hodgkin’s lymphoma (cHL) is a rather rare disease with an incidence of 2-3/100,000 per year and typically presents in patients at the age of 20–30. It is however well known that a second peak occurs at the age of 60–65 years.1 Nowadays Hodgkin is a curable disease for most of the younger patients but treatment is more difficult and less successful in the older patient population. In this review, we want to summarise the possibilities for the treatment of cHL patients above 60 years, with a focus on evidence from the rather rarely available clinical trials. We also look at future treatments. In this article we will use the term ‘older patients’ for patients of 60 years and older at diagnosis. We will make a distinction between fit patients older than 60 years and frail or vulnerable patients (so called elderly).
A. Janssens MD, PhD, L. Stas MSc, M. Van den Enden MD, E. Van den Neste MD, PhD
SUMMARY
Chronic lymphocytic leukaemia (CLL) is a slow-progressing cancer that results in uncontrolled proliferation and accumulation of B-lymphocytes in the blood and bone marrow and is the most common form of leukaemia in the western world. CLL patients harbouring a deletion of chromosome 17 (del17p) or the TP53 mutation, who progress after treatment with immunological, chemotherapeutic as well as targeted agents such as ibrutinib have poor prognosis signifying a population with an unmet medical need. Clinical studies showed that venetoclax, a selective; orally bioavailable Bcl-2 inhibitor, induces CLL cell apoptosis, and offers an alternative therapeutic option for CLL, either as a monotherapy or in combination with rituximab. BRAVe was a multicentre, observational retrospective study, conducted in Belgium. The main objectives of this study were to evaluate the safety and effectiveness of venetoclax monotherapy in Belgian patients with CLL, as well as the utilisation of resources in a real life setting. The results show a manageable/favourable safety profile for venetoclax with limited burden for patients and sites, and a good overall response rate in pre-treated CLL patients in the relapsed/refractory setting.
G. Swennen MD, A. Janssens MD, PhD, V. Vergote MD, S. Bailly MD, C. Bonnet MD, PhD, E. Van den Neste MD, PhD, M. Maerevoet MD, S. Snauwaert MD, PhD, K. Saevels MD, C. Jacquy MD
SUMMARY
Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma. Prognosis of diffuse large B-cell lymphoma has improved dramatically since the introduction of rituximab and about two thirds of patients can be cured with immunochemotherapy. In the last twenty years, it became clear that diffuse large B-cell lymphoma is a very heterogeneous disease and based on the genetic mutation landscapes numerous efforts have been made to develop novel treatment strategies to improve the prognosis of diffuse large B-cell lymphoma further. This article provides an update of diagnosis, current treatment guidelines and novel treatment strategies for newly diagnosed patients with diffuse large B-cell lymphoma in Belgium. It will also focus on treatment of elderly patients and high-grade B-cell lymphoma.
BJH - volume 11, issue Abstract Book BHS, february 2020
I. Dufour , G. Verstraete , J. Raedemaeker , F. Andreozzi , L. Bamps , S. Chabert , A. Sogorb , S. Bailly MD, E. Van den Neste MD, PhD, X. Theunssens , F. Tamirou , D. Tennstedt , A. Camboni MD, PhD, M-C. Vekemans MD, PhD
D. Bron MD, PhD, M. Maerevoet MD, E. Van den Neste MD, PhD, V. Delrieu MD, F. Offner MD, PhD, W. Schroyens MD, PhD, A. Van Hoof MD, PhD, G. Verhoef MD, PhD, J.B. Giot MD, J.P. Loly MD, A. Janssens MD, PhD, C. Bonnet MD, PhD
Marginal zone lymphomas (MZL) are a heterogeneous subtype of indolent B-non-Hodgkin lymphomas that includes distinct entities:
Extranodal mucosa-associated lymphoid tissue lymphoma arises in a variety of tissue but primarily in the stomach. They are usually localised and often associated with chronic antigenic stimulation by microbial pathogens. Eradication of the pathogen is a major part of the first-line therapy. The prognosis is excellent in early stages. In advanced stages, observation, anti-CD20 antibodies and/or cytostatic drugs are therapeutical approaches.
Nodal MZL is usually confined in lymph nodes, bone marrow and peripheral blood. The prognosis is somewhat worse in this entity. Current recommendations suggest that they should be managed as follicular lymphomas.
Splenic MZL is a unique entity involving the spleen, bone marrow and blood. Hepatitis infection should be eradicated before considering treatment. These lymphomas have an indolent behaviour, and only symptomatic patients should be treated by splenectomy and/or anti-CD20 antibodies.
Two novel entities are described, non-chronic lymphocytic leukaemia monoclonal B-cell lymphocytosis, probably closely related to splenic MZL lymphoma, and a less well-defined provisional entity involving primarily the spleen called splenic B-cell lymphoma/leukaemia, unclassifiable, including splenic diffuse red pulp lymphoma and hairy-cell leukaemia variant.
This review will discuss separately the diagnosis, work-up and treatment of extranodal mucosa-associated lymphoid tissue lymphoma, nodal MZL and splenic MZL. These guidelines include the recently published ESMO consensus conference on malignant lymphoma.1–3
C. Bonnet MD, PhD, M.C. Ngirabacu , M. Maerevoet MD, V. De Wilde MD, PhD, E. Van den Neste MD, PhD, M. André MD, PhD
SUMMARY
The 4th edition of the LYSA meeting was organised by Professor Steven Legouill’s team and held in Nantes from the 8th to 10th February, 2018. It was a real opportunity for the 500 participants to learn novelties on lymphoma and to be updated on ongoing clinical trials conducted by this cooperative group. All the presentations were outstanding and gave us new indications on how to better treat our patients in the near future.
