Articles

Practical recommendations for the management of late relapsed and refractory multiple myeloma in 2024

BJH - volume 15, issue 6, october 2024

N. Kint MD, PhD, M.C. Vekemans MD, N. Meuleman MD, PhD, J. Caers MD, PhD, C. Doyen MD, J. Depaus MD, R. Callens MD, G. Claes MD, C. Jacquy MD, PhD, A. Kentos MD, PhD, H. Maes MD, F. Offner MD, PhD, A. Salembier MD, R. Schots MD, PhD, K. Theunissen MD, I. Vande Broek MD, PhD, A. Van De Velde MD, PhD, K.L. Wu MD, PhD, M. Delforge MD, PhD

SUMMARY

Despite significant advances in therapeutic modalities, the treatment of relapsed and refractory multiple myeloma (RRMM) is still challenging. In this publication, we aim to provide an update on therapeutic modalities for RRMM in Belgium. First, novel combinations of well-established therapeutic agents will be discussed. Second, T-cell redirection therapies will be addressed. These include bispecific antibodies, both anti-BCMA x CD3 and anti-GPRC5D x CD3, as well as chimeric antigen receptor (CAR) T cell therapy. Third, we discuss novel modalities such as antibody-drug conjugates, selinexor, venetoclax, melflufen and CELMoDs. Finally, a general flowchart regarding overall treatment sequencing will be proposed, providing an integrated treatment recommendation from frontline to relapse.

(BELG J HEMATOL 2024;15(6):225–32)

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Highlights in multiple myeloma

BJH - volume 15, issue 5, september 2024

N. Meuleman MD, PhD

SUMMARY

During the last European Hematology Association (EHA) congress in Madrid, there were several presentations on the treatment of newly diagnosed and relapsed multiple myeloma. These included results from phase III trials, which will again change our treatment guidelines in the near future.

(BELG J HEMATOL 2024;15(5):190–2)

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Multiple myeloma: Practical recommendations for the management of early relapses 2024

BJH - volume 15, issue 4, june 2022

M.C. Vekemans MD, N. Kint MD, PhD, G. Claes MD, C. Doyen MD, V. Galle MD, C. Jacquy MD, PhD, H. Maes MD, N. Meuleman MD, PhD, O. Rizzo MD, A. Salembier MD, H. Schots MD, PhD, G. Verstraete MD, M. Delforge MD, PhD

SUMMARY

Despite the increasing availability of more effective treatments for newly diagnosed multiple myeloma (NDMM) patients that provide longer disease-free periods, almost all patients will experience a relapse. Managing relapse after regimens that have included a proteasome inhibitor (PI), an immunomodulatory drug (IMID), and often an anti-CD38 monoclonal antibody can be challenging, but therapeutic options have greatly increased over the past decades. This review covers the current second-line therapeutic options and provides updated information on novel agents for the treatment of early relapses in MM patients.

(BELG J HEMATOL 2024;15(4):158–64)

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Multiple myeloma: Practical recommendations for front-line therapy 2024

BJH - volume 15, issue 3, may 2024

M.C. Vekemans MD, N. Meuleman MD, PhD, N. Kint MD, PhD, G. Claes MD, C. Doyen MD, V. Galle MD, C. Jacquy MD, PhD, H. Maes MD, O. Rizzo MD, A. Salembier MD, H. Schots MD, PhD, G. Verstraete MD, M. Delforge MD, PhD

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. Different treatment combinations are now in use and quadruplets have been investigated with success. 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 2024;15(3):103–16)

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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, A. de Weweire MD, R. Schots MD, PhD, M. Delforge MD, PhD, M.C. Vekemans MD

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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