Articles

Primary gastric plasmacytoma: Case report of a rare plasma cell neoplasm

BJH - volume 12, issue 8, december 2021

O. Rizzo MD, D. Bron MD, PhD, M. Vercuyssen MD, A. De Wind MD, PhD, M. Roelandt MD, P. Eisendrath MD, PhD, A. Lemmers MD, PhD, N. Meuleman MD, PhD

SUMMARY

A 46-year-old woman presented with epigastric pain and weight loss for over a year. An upper endoscopy was performed and showed a polypoid lesion in the antropyloric region. Immuno-pathological report revealed a proliferation of plasma cell nature. The whole work-up including complete blood test, bone marrow biopsy and 18FDG-PET-CT did not detect extra gastric lesion of multiple myeloma. The diagnosis of extramedullary plasmacytoma of the stomach was established. Radiotherapy (44 Gy) with a curative intent was administered but the control biopsy showed residual disease. Endoscopic submucosal dissection was then performed with R0 resection (negative margins) leading to complete remission.

(BELG J HEMATOL 2021;12(8):349–52)

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Guidelines of the Belgian Hematology Society for imaging in multiple myeloma

BJH - volume 12, issue 8, december 2021

N. Meuleman MD, PhD, J. Caers MD, PhD, K. Fostier MD, P. Vlummens MD, S. Pans MD, L. Goethals MD, PhD, J. Alexiou MD, M. Cliquennois MD, C. Doyen MD, PhD, A. de Weweire MD, R. Schots MD, PhD, M. Delforge MD, PhD, M-C. Vekemans MD, PhD

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)

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Highlights in multiple myeloma

BJH - volume 12, issue 5, september 2021

N. Meuleman MD, PhD, M. Vercruyssen MD

SUMMARY

Major progress has been made in the treatment of Multiple Myeloma (MM) and new current standard of care has been recently published and includes the introduction of triplet and quadruplet combinations, even in first-line, and the concept of continuous treatment.1 Several new drugs and new associations have been approved and have considerably improved the prognosis of the patients. However, MM remains an incurable disease and patients with high-risk (HR) disease will still experience early relapse. During the European Hematology Association’s annual congress (EHA 2021), results from different trials have highlighted the best options for HR MM, the role of autologous stem cell transplantation, and the exciting results of new anti BCMA-targeting therapy, and have confirmed the results of daratumumab based therapy in first-line treatment.

(BELG J HEMATOL 2021;12(5):220-2)

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Rational approach of older patients with chronic lymphocytic leukaemia

BJH - volume 12, issue 4, june 2021

F. Massaro MD, C. Vandevoorde , J. Ku MD, D. Papazoglou MD, A. Van Uytvanck MD, N. Meuleman MD, PhD, D. Bron MD, PhD

SUMMARY

The majority of CLL patients are elderly, with a median age of those requiring a first line treatment, close to 76 years old. Nowadays, multiple treatment options are available for this disease, ranging from chemo immunotherapy regimens to biological therapies. The treatment decision in an older CLL patient is a four-step procedure, starting firstly with the assessment of treatment criteria. The second step is to evaluate the life-expectancy of the patient, its autonomy, vulnerabilities and the socio-economic status. The subsequent step is to define treatment options according to prognostic factors. Last, but not least, the patient should be involved in the final decision to know to what extend he is willing to receive a treatment with a potential curative or palliative intent. The assessment of an elderly CLL patient is a complex procedure, not only comprehending the evaluation of biological and hematological parameters but also clinical, social and psychological features, which equally contribute to the selection of the most valuable strategy.

(BELG J HEMATOL 2021;12(4):147-54)

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POEMS Syndrome

BJH - volume 11, issue 8, december 2020

N. Meuleman MD, PhD, C. Doyen MD, PhD, J. Depaus MD

SUMMARY

Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome is a rare disorder due to an underlying plasma cell clone (PC). The syndrome can affect several organs. The diagnosis is based on the presence of mandatory criteria (polyneuropathy, monoclonal plasma cell disorder) and at least one major and one minor criteria. The therapeutic regimen is determined according to the extent of the patient’s sclerotic lesions and the presence of bone marrow involvement.

(BELG J HEMATOL 2020;11(8):381-6)

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Practical management of multiple myeloma: Update 2020

BJH - volume 11, issue 8, december 2020

M-C. Vekemans MD, PhD, C. Doyen MD, PhD, K.L. Wu MD, A. Kentos MD, PhD, P. Mineur MD, L. Michaux MD, PhD, J. Caers MD, PhD, N. Meuleman MD, PhD, M. Delforge MD, PhD, On behalf of the BHS Myeloma Subgroup

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)

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Diagnosis and treatment of AL amyloidosis: Belgian guidelines

BJH - volume 11, issue 8, december 2020

N. Meuleman MD, PhD, M. Vercruyssen MD, M. Cliquennois MD, J. Caers MD, PhD, C. Doyen MD, PhD, G. Bries MD, PhD, C. Jacquy MD, M. Delforge MD, PhD, M-C. Vekemans MD, PhD

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)

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