M. Delforge MD, PhD

Practical management of newly-diagnosed multiple myeloma: 2018 update for transplant eligible patients

With the introduction of immunomodulatory agents and proteasome inhibitors, major improvements have been achieved in the treatment and outcome of multiple myeloma. Different treatment combinations are now in use and newer therapies are being developed. Nevertheless, autologous stem cell transplantation remains the corner stone of therapy for fit, newly-diagnosed multiple myeloma patients. Based on an extensive review of the recent literature, we propose recommendations on myeloma care, to be used by haematologists as a reference for daily practice.

(BELG J HEMATOL 2019;10(3):113–21)

Practical management of newly-diagnosed multiple myeloma: 2018 update for transplant eligible patients

SUMMARY

With the introduction of immunomodulatory agents (IMiDs) and proteasome inhibitors (PIs), major improvements have been achieved in the treatment and outcome of multiple myeloma (MM). Different treatment combinations are now in use and newer therapies are being developed. Nevertheless, autologous stem cell transplantation (ASCT) remains the corner stone of therapy for fit, newly-diagnosed MM patients. Based on an extensive review of the recent literature, we propose recommendations on myeloma care, to be used by haematologists as a reference for daily practice.

Management of relapsed and refractory multiple myeloma patients

SUMMARY

For the majority of multiple myeloma (MM) patients, their disease will behave as a chronic disorder with episodes of remission followed by disease progression. Whereas the treatment approach in frontline is rather uniform, treatment at relapse has become more heterogeneous, as therapeutic choices at this stage are driven by many factors including disease characteristics and patient status, but also the previous treatment(s), their therapeutic effect and toxicities, and drug availability. With each treatment course patients also tend to become more vulnerable to hematological and non-hematological toxicities. Therefore, particularly at later relapses where there is no standard of care, the benefits and potential risks of therapeutic decisions should be carefully balanced in each individual patient, to minimize excess toxicities. In this review article, an overview is provided of the currently available treatment options for patients with relapsed or refractory MM.

PP23 A simple frailty score to identify patients with malignant hemopathies who don’t benefit from standard dose chemotherapy

P37 Comparison of Multigam^® IV (5% vs. 10%) in hematological patients with secondary immunodeficiencies to evaluate infusion time, tolerability and satisfaction. A monocentric observational Belgian study

Myopathy as a rare presentation of AL amyloidosis

SUMMARY

Amyloid myopathy is a rare manifestation of amyloid light chain amyloidosis. We present a case of a 41-year old male with multiple myeloma with muscle hypertrophy, muscle weakness and enlargement of the submandibular glands as the only presenting clinical symptoms, illustrating the sheer difficulty of diagnosing amyloid light chain amyloidosis in patients with mainly soft tissue involvement. Even if there is a clinical suspicion, it is often hard to verify as Congo red stain and immunohistochemistry on muscle biopsy are not always reliable. After bortezomib-based induction treatment followed by autologous stem cell transplantation with high dose melphalan conditioning, he achieved complete haematological remission as well as a significant clinical response. We would like to highlight the importance of early diagnosis and treatment, as progression to more extensive visceral involvement can lead to rapid occurrence of organ failure and death.

(BELG J HEMATOL 2017;8(3):113–7)

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)