K. Fostier MD

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)

Highlights in Multiple Myeloma

Of the 4,872 abstracts presented during the 2018 annual meeting of the American Society of Hematology (ASH), almost a quarter was dedicated to MM, illustrating continued interest and research in this dismal disease. This text is but a small anthology on the most exciting abstracts on MM as presented at ASH 2018.

(BELG J HEMATOL 2019;10(1):20–3)

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.

Successful treatment of immunoglobulin light chain amyloidosis with associated factor X deficiency

SUMMARY

Bleeding diathesis in light chain amyloidosis may be due to an acquired coagulation factor deficiency, most commonly factor X deficiency. This report describes the case of an elderly myeloma patient with associated light chain amyloidosis, nephrotic syndrome and factor X deficiency. Treatment with nine cycles of subcutaneous bortezomib + melphalan + prednisone resulted in a complete haematological remission with resolution of the nephrotic syndrome and normalisation of coagulation tests. This case report highlights the importance of performing coagulation screening tests in light chain amyloidosis. In addition, it illustrates that bortezomib-based regimens can induce rapid and complete haematological response with long-term correction of factor X levels.

(BELG J HEMATOL 2017;8(7):272–5)

Update on therapy of relapsed and refractory multiple myeloma

SUMMARY

The prognosis for multiple myeloma patients has improved substantially over the past decade with the development of more effective chemotherapeutic agents and regimens that possess a high level of anti-tumour activity. However, nearly all multiple myeloma patients ultimately relapse, even those who experience a complete response to initial therapy. Management of relapsed disease remains a critical aspect of multiple myeloma care and an important area of ongoing research. This manuscript from the Belgian Haematology Society multiple myeloma subgroup provides some recommendations on the management of relapsed disease.

(BELG J HEMATOL 2017;8(2):53–65)

A-133 ACQUIRED HAEMOPHILIA A

Highlights related to plasma cell disorders

Summary

The field of multiple myeloma (MM) treatment and related plasma cell disorders is ever expanding. New drugs are introduced at a fast pace potentially making things complicated for the treating haematologist. Furthermore, the disease is very heterogeneous and no patient is alike. ASH offers professionals the annual opportunity to witness the joint efforts made by patients, basic scientists, clinicians and the pharmacological industry in fighting this disease. This text is but a small anthology on the most exciting clinical data on plasma cell disorders as presented at ASH 2015.

(BELG J HEMATOL 2016; 7(1):34–8)