M. Delforge MD, PhD

P3.02 Autologous Hematopoietic Stem Cell Transplantation in Crohn’s Disease: Results from our first 14 patients

Update on the initial therapy of multiple myeloma

Summary

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)

New drugs in multiple myeloma

Summary

During the last decade, thalidomide, lenalidomide and bortezomib have significantly improved the outcome for patients with multiple myeloma. Although still frequently referred to as ‘novel agents’, a newer generation of more potent proteasome inhibitors and immunomodulatory drugs are expected to enter the myeloma clinic in the near future. New proteasome inhibitors like carfilzomib have shown unprecedented anti-myeloma activity, particularly when combined with lenalidomide and dexamethasone. Other proteasome inhibitors under development will be more patient-friendly by becoming orally available. In the class of immunomodulatory drugs, it is expected that pomalidomide will be registered in the near future for refractory myeloma patients, based on convincing phase III data. Finally, after many years of research, myeloma also has its monoclonal antibodies. Daratumumab and elotuzumab are evaluated in several clinical studies. All these new agents will not replace the current, yet not old, anti-myeloma drugs. The major challenge will become to prove that optimal drug sequencing or combination, guided by science and clinical experience, will continue to prolong the life expectancy of patients with multiple myeloma.

(BELG J HEMATOL 2014;5(2):55–9)

P4.02 The effect of multipotent adult progenitor cells on bone marrow failure in myelodysplastic syndromes

P2.18 Responding patients show durable responses to bendamustine in double refractory multiple myeloma patients

Systemic mastocytosis: overview and new insights in prognosis and therapy

Summary

Systemic mastocytosis is an orphan myeloproliferative disease characterised by an excessive mast cell accumulation. Benign forms present with urticaria pigmentosa while aggressive subtypes or leukaemic variants lead to organ dysfunction. In patients with unexplained hypotensive syncope’s or anaphylaxis, flushing and angio-oedema with a basal tryptase >20 ng/mL, one should think of systemic mastocytosis. Pathophysiology is based on mutations in KIT, encoding the c-kit receptor (CD117) on the surface of mast cells. Diagnosis is based on bone marrow biopsies with clusters of atypical mast cells and co-expression of CD2 or CD25 and/or a KIT mutation. Treatment consists of avoiding triggers of mast cell release and antihistaminic drugs. Patients with aggressive subtypes are candidates for cytoreductive therapies. CD30 is thought to be a novel predictor of prognosis.

(BELG J HEMATOL 2013;4(3):85–89)

P.21 Coincidence of renal cell carcinoma and post-transplant lymphoproliferative disorder following kidney transplantation