BJH - volume 15, issue 8, december 2024
E. De Bondt MD, J. Brijs MD, T. Tousseyn MD, PhD, P. Vanbrabant MD, H. Schoemans MD, PhD, L. Henckaerts MD, PhD
We report the case of a 32-year-old female patient who was sent to the emergency department because of nocturnal fever, night sweats, pancytopenia and an elevated CRP. Clinical examination showed a pale patient with a splenomegaly of 17.6 cm. Standard blood tests for infectious diseases remained negative. Travel history revealed a trip to Spain seven months ago. Leishmania serology on blood and polymerase chain reaction (PCR) on bone marrow were found positive. The diagnosis of visceral leishmaniasis was made and the patient was treated with intravenous amphotericin B, with a rapid clinical and biochemical recovery. Leishmaniasis is a (sub)tropical, vector-borne disease caused by intracellular protozoan parasites, spread by sand-flies. Visceral leishmaniasis is the most severe form and presents in a nonspecific way. This case illustrates the importance of a good work-up of pancytopenia, a relatively frequent medical condition with multiple causes. The possibility of visceral leishmaniasis should not be forgotten, especially in case of a suggestive travel history.
(BELG J HEMATOL 2024;15(8):329–32)
Read moreBJH - volume 15, issue 4, june 2024
J. Brijs MD, M. André MD, PhD, S. Bailly MD, K. Beel MD, PhD, C. Bonnet MD, G. Crochet MD, P. De Paepe MD, PhD, D. Dierickx MD, PhD, C. Jacquy MD, PhD, K. Saevels MD, S. Snauwaert MD, PhD, E. Van den Neste MD, PhD, V. Vergote MD
Diffuse large B-cell lymphoma (DLBCL) is an aggressive B-cell lymphoma and represents the most common subtype of B-cell non-Hodgkin lymphomas. The majority of patients (60–70%) can nowadays be cured with first line chemo-immunotherapy (CIT), mostly a combination of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). The remaining 30–40% of patients with relapsing or refractory (R/R) disease have an unfavourable prognosis. Until recently, these patients could only be cured with platinum-based salvage CIT followed by high-dose chemotherapy and an autologous stem cell transplantation, but with rather disappointing outcomes. However, new and promising treatments for these patients have now found their way into clinical practice, with good response and survival rates and manageable toxicity rates. This article will briefly review the latest advances in the treatment of DLBCL in Belgium, both for newly diagnosed disease and for R/R disease. We will focus on the role of polatuzumab vedotin in first line, chimeric antigen receptor (CAR) T-cell therapy in second line, tafasitamab-lenalidomide in second line or higher, and bispecific antibodies in third line or higher. New treatment algorithms, both for untreated and for R/R DLBCL, clinically oriented and adapted to the Belgian reimbursement criteria, are also presented.
(BELG J HEMATOL 2024;15(4):147–57)
Read moreBJH - volume 14, issue 2, march 2023
J. Brijs MD, J. Neefs PharmD, A. Janssens MD, PhD
Lymphomas are the most common haematological malignancy and represent a heterogenous group of lymphoproliferative diseases with a variable prognosis. Chemotherapy and radiotherapy, and anti-CD20 immunotherapy for B-cell lymphomas, currently form the basis of lymphoma treatment. New agents, especially new forms of cancer immunotherapy, such as bispecific antibodies (bsAbs), have expanded therapeutic approaches in the last years. bsAbs have two different antigen binding sites, which enables them to simultaneously target tumour cells and immune effector cells (T-cells). By binding and activating T-cells in the proximity of tumour cells, an effective T-cell mediated anti-tumour response can be achieved. Target antigens in lymphomas are mostly CD19 or CD20 on the malignant B-cell and CD3 on the T-cell. This article will briefly review the basic principles and mechanisms of action of bsAbs, discuss the molecules approved or in advanced clinical development for lymphomas with their most relevant (dose-escalation/dose-expansion) trials, and pay attention to possible adverse events and future perspectives of bsAbs.
(BELG J HEMATOL 2023;14(2):67–72)
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