BJH - volume 6, issue 5, december 2015
A. Janssens MD, PhD, E. Van den Neste MD, PhD, F. Offner MD, PhD, D. Bron MD, PhD
The Belgian Hematological Society Lymphoproliferative Working Party updated the 2012 recommendations on the best strategies for front-line and subsequent-line treatment of small lymphocytic leukaemia/chronic lymphocytic leukaemia. No treatment is necessary for patients without active and/or advanced disease, regardless of prognostic factors. When front-line treatment is indicated we recommend adding an anti-CD20 monoclonal antibody to chemotherapy except in frail patients: fludarabine, cyclophosphamide, rituximab for fit patients; bendamustine, rituximab for fit patients >65 years or unfit for fludarabine, cyclophosphamide, rituximab; and chlorambucil with obinutuzumab or rituximab for older patients with a geriatric profile, major comorbidities or a reduced performance status. The choice of treatment for patients with recurrent disease depends on the duration of response to the previous treatment, the type of treatment refractoriness and the presence of a 17p deletion/p53 mutation. As an alternative, chemoimmunotherapy can be proposed for patients with a late relapse. The novel B-cell receptor inhibitors are the best choice for those relapsing early, who have refractory disease or are unfit for chemoimmunotherapy. The B-cell receptor inhibitors are also first choice for each patient with a de novo or acquired 17p deletion/p53 mutation. Reduced intensity conditioning allogeneic stem cell transplantation should still be considered for patients with high-risk disease after response induction by the B-cell receptor inhibitors. We still have to encourage patients to enter clinical trials exploring new drug combinations.
(BELG J HEMATOL 2015;6(5): 195–202)
Read moreBJH - volume 5, issue 4, december 2014
M-C. Vekemans MD, K. Beel MD, PhD, J. Caers MD, PhD, N. Meuleman MD, PhD, G. Bries MD, PhD, V. Delrieu MD, H. Demuynck MD, B. De Prijck MD, H. De Samblanx MD, A. Deweweire MD, A. Kentos MD, PhD, P. Mineur MD, F. Offner MD, PhD, I. Vande Broek MD, PhD, A. Vande Velde MD, J. Van Droogenbroeck MD, KL. Wu MD, PhD, C. Doyen MD, PhD, R. Schots MD, PhD, M. Delforge MD, PhD
With the introduction of immunomodulatory drugs and proteasome inhibitors, major improvements have been achieved in the treatment and prognosis of multiple myeloma. Different treatment combinations are now in use and innovative therapies are being developed. This rapidly changing therapeutic landscape calls for an update on the Belgian myeloma guidelines, published in 2010.1 Based on an extensive review of the recent literature, the myeloma study group of the Belgian Hematology Society has revised the consensus recommendations on myeloma care, to be used by haematologists as a reference for daily practice. When applicable, comments with regards to the Belgian reimbursement modalities are included. The full text with appendices can be downloaded from the Belgian Hematology Society website (www.bhs.be) and from the Belgium Journal of Hematology website (www.ariez.com).
(BELG J HEMATOL 2014;5(4):125–36)
Read moreBJH - volume 5, issue 1, march 2014
D. Bron MD, PhD, E. Van den Neste MD, PhD, A. Kentos MD, PhD, F. Offner MD, PhD, W. Schroyens MD, PhD, C. Bonnet MD, PhD, A. Van Hoof MD, PhD, G. Verhoef MD, PhD, A. Janssens MD, PhD
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)
Read moreBJH - volume 4, issue 3, september 2013
F. Van Obbergh MD, A. Van Hoof MD, PhD, G. Verhoef MD, PhD, D. Dierickx MD, PhD, V. De Wilde MD, PhD, F. Offner MD, PhD, D. Bron MD, PhD, A. Sonet MD, M. André MD, PhD, A. Janssens MD, PhD, C. Bonnet MD, PhD, B. Deprijck MD, P. Zachée MD, PhD, A. Kentos MD, PhD, W. Schroyens MD, PhD, E. Van den Neste MD, PhD
The sub-committee on lymphoproliferative disorders of the Belgian Hematological Society has met several times to prepare guidelines on the management of patients with peripheral T-cell lymphomas. Each panellist’s expert provided interpretation of the evidence, based on literature review and personal experience. The available evidence was systematically discussed prior to formulating recommendations. A systematic approach to obtain consensus of expert opinion was used. After each meeting, the draft guideline was circulated to all experts for comment and approval. The present guidelines focus on general management of peripheral T-cell lymphomas with special emphasis on more specific disease-adapted strategies.
(BELG J HEMATOL 2013;4(3):90–101)
Read moreBJH - 2013, issue BHS Abstractbook, january 2013
P. André , E. Van den Neste MD, PhD, G. Verhoef MD, PhD, D. Bron MD, PhD, A. Van Hoof MD, PhD, P. Zachée MD, PhD, S. van Steenwegen , B. De Prijck MD, N. Straetmans MD, PhD, M. Maerevoet MD, D. Boulet , F. Offner MD, PhD, P. Pierre , V. Mathieux MD, PhD, P. Mineur MD, T. Connerotte MD, M. Federico , J. Raemaekers
BJH - volume 3, issue 4, december 2012
A. Janssens MD, PhD, E. Van den Neste MD, PhD, W. Schroyens MD, PhD, M. André MD, PhD, A. Van Hoof MD, PhD, V. De Wilde MD, PhD, G. Verhoef MD, PhD, F. Offner MD, PhD, D. Bron MD, PhD
Tremendous improvements in treatment outcome have been obtained over the past decade but for most of the patients chronic lymphocytic leukaemia (CLL) still remains an incurable disease. We eagerly await tools incorporating patient related, disease related and treatment related factors, in order to balance efficacy and toxicity and to personalise treatment in a more rational manner. No treatment is necessary for patients without active and/or advanced disease, regardless of prognostic factors. When treatment is indicated we recommend fludarabine, cyclophosphamide, rituximab (FCR) as front-line strategy for fit patients, bendamustine, rituximab (BR) for patients unfit for FCR and chlorambucil for older patients with a geriatric profile or patients with major comorbidities or a reduced performance status. The choice of treatment for patients with recurrent advanced and/ or active disease depends on the duration of response to the previous treatment and on the type of treatment refractoriness. Reduced intensity conditioning allogeneic stem cell transplantation should be considered for patients with a de novo or an acquired 17p deletion, for patients refractory to F, or F and alemtuzumab, or for patients with an early relapse after chemo-immunotherapy.
We encourage patients to enter clinical trials exploring new agents. Among these new approaches, the signal transduction inhibitors have shown remarkable activity in very advanced disease, independent of genetic aberrations.
(BELG J HEMATOL 2012;3: 134–143)
Read moreBJH - volume 3, issue 2, june 2012
S. Debussche MD, A. Van Hoof MD, PhD, A. Sonnet MD, PhD, C. Bonnet MD, PhD, A. Janssens MD, PhD, G. Verhoef MD, PhD, D. Dierickx MD, PhD, V. De Wilde MD, PhD, D. Bron MD, PhD, W. Schroyens MD, PhD, E. Van den Neste MD, PhD, F. Offner MD, PhD
Follicular lymphoma is an indolent lymphoma that has occurred more frequently over the last decades. In this article we present an overview of the diagnosis and initial work-up, prognostic scoring system and choice of therapy. For limited stage disease radiotherapy is the treatment of choice, and may have a curative potential. For advanced stages treatment should be initiated upon certain criteria, and is essentially based on immunochemotherapy, rituximab plus chemotherapy. The choice of chemotherapy depends on age, frailty, and specific toxicities of chemotherapy. Maintenance therapy with rituximab after induction has become standard practice. Since virtually all patients relapse eventually, an overview of the treatment in the relapsed setting is given. The treatment is then again based on immunoche-motherapy but there is also a place for radio-immunotherapy, or immunotherapy alone. For young patients, high dose chemotherapy with autologous stem cell rescue should be considered. A brief overview on novel agents, and agents that are in the pipeline, is given. We conclude with some recommendations for follow-up.
(BELG J HEMATOL 2012;3:41–50)
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