Articles

Vaccination policy in adult patients with hematological malignancies or asplenia without stem cell transplantation: Recommendations from the advisory board on vaccination of the Belgian Hematological Society

BJH - volume 11, issue 7, november 2020

J. Loos MD, M. Beckers MD, PhD, V. Beckers MD, M. Hoyoux MD, prof. dr. W. Peetermans MD, PhD, A. Van De Velde MD, V. Van Hende MD, A. Vanderfaeillie MD, Y. Van Laethem MD, PhD, A. Janssens MD, PhD

SUMMARY

Patients with hematological malignancies suffer from widely varying degrees of immunodeficiency, which leads to an increased susceptibility to a wide range of infections. Some of these, such as influenza and invasive pneumococcal disease, are vaccine preventable. During the Covid19 pandemic these past months patients with hematological malignancies have already shown to be at greater risk of dying, with mortality rates of up to 30% in hospitalized patients.1,2 This has once again highlighted the importance of robust and widely spread vaccination strategies, also we eagerly await an available vaccine for Covid19. In this review, the advisory board on vaccination of the Belgian Hematological Society (BHS), consisting of experts from various disease committees as well as two infectious disease experts attempts to provide clear recommendations regarding vaccinations in patients with hematological malignancies and asplenia. Although transplant recipients share many of the immunodeficiencies of those not transplanted, clear guidelines and vaccination schedules have already been published.3

(BELG J HEMATOL 2020;11(7):305-316)

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

BJH - volume 8, issue 7, december 2017

V. Beckers MD, R. Schots MD, PhD, K. Fostier MD

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)

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