J. Caers MD, PhD

Guidelines of the Belgian Hematology Society for imaging in multiple myeloma

SUMMARY

Despite major improvements in the diagnosis and treatment of multiple myeloma (MM), bone damage remains a major feature of this disease. With the development of new diagnostic tools, conventional skeletal studies have been progressively replaced by novel imaging techniques. Today, imaging plays a crucial role in defining symptomatic multiple myeloma, measurement of the extent of skeletal involvement and assessing therapeutic response including minimal residual disease (MRD). Based on an extensive review of the recent literature, we propose an array of Belgian recommendations for myeloma imaging to be used as a reference by haematologists in their daily practice.

(BELG J HEMATOL 2021;12(8):338–43)

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)

Diagnosis and treatment of AL amyloidosis: Belgian guidelines

SUMMARY

Immunoglobulin light chain (AL) amyloidosis is a rare and serious disease due to the deposition of amyloid fibrils. In the past years, improvements have been made in the diagnosis, treatment and response criteria. Based on an extensive review of the recent literature on AL amyloidosis, we propose practical recommenddations that can be used by Belgian haematologists as a reference for daily practice. Management of other types of amyloidosis will not be covered by this review. Levels of evidence and grades of recommendations are based on previously published methods.¹ We recommend participation in clinical trials to gain knowledge in this evolving field.

(BELG J HEMATOL 2020;11(8):343-56)

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)

PP.03.2 Improvement of antibody-induced cell death in multiple myeloma

What is new in MGUS and smoldering multiple myeloma

SUMMARY

Multiple Myeloma (MM) and other plasma cell malignancies initially present as an asymptomatic precursor state, known as monoclonal gammopathy of undetermined significance (MGUS). When confronted to a monoclonal protein in blood or urine tests, physicians should first exclude the presence of a treatment-requiring MM. They should be aware that there are two benign precursor states, that do not require anti-myeloma treatment. Both MGUS and Smoldering Multiple Myeloma (SMM) need an initial visit by a haematologist, with further follow-up tailored to the individual patient and disease characteristics. In the current article we describe both entities, discuss their monitoring and resume the latest publications in their field.

Diagnosis and monitoring of multiple myeloma patients

SUMMARY

The diagnosis of multiple myeloma (MM) can be challenging, especially in patients with light-chain or non-secretory disease. The disease should be excluded in patients presenting with unexplained anaemia or renal failure and suspected in patients with signs of back pain combined with other systemic symptoms, such as fatigue and weight loss, or back pain combined with abnormal blood tests. The diagnosis is based on clinical, biological and radiological abnormalities that are resumed in the current article. At diagnosis, additional cytogenetic testing is important to determine the prognosis and guide physicians in their treatment choices. The disease is generally monitored by quantifying the monoclonal proteins in blood or urine. The follow-up of patients can be further tailored to the patients’ general status, obtained response and disease characteristics.