BJH - volume 9, issue 7, december 2018
dr. A. Delie MD, T. Kerre MD, PhD, I. Moors MD
Since several years, it has become clear that intermediate-risk acute myeloid leukaemia patients in an acceptable clinical condition can benefit from allogeneic stem cell transplantation thanks to the improvement in relapse free survival. This study retrospectively analysed the outcome of all intermediate-risk acute myeloid leukaemia patients treated with intensive chemotherapy at the Ghent University Hospital between 01-01-2013 and 30-04-2017 in an effort to determine the impact of a new in-hospital treatment guideline adopted in April 2015. This guideline recommends all intermediate-risk acute myeloid leukaemia patients who are fit for intensive therapy to proceed to allogeneic stem cell transplantation in first complete remission. Unfortunately, we could not demonstrate an improvement in the relapse free survival after implementation of the treatment guideline. Nevertheless, exploratory analysis of the entire group suggests a survival benefit from allogeneic stem cell transplantation, with significantly improved relapse free survival and a trend towards a better overall survival.
(BELG J HEMATOL 2018;9(7):285–9)
Read moreBJH - volume 9, issue 6, november 2018
K.N. De Paepe , R. Oyen , G. Verhoef MD, PhD, V. Vandecaveye
Diffusion-weighted magnetic resonance imaging (DW/MRI) is a radiation-free functional imaging technique reflecting tissue cellularity by probing the diffusion of water molecules on a microstructural level. This can be assessed visually, but also quantified by calculating the apparent diffusion coefficient (ADC). Although established in many solid tumours and multiple myeloma, its role in disease assessment in malignant lymphoma has yet to be determined. Therefore, the main purpose of this work was twofold: exploring the performance of whole-body DW/MRI (WB-DW/MRI) in staging malignant lymphoma and assessing treatment response early during treatment with 18F-FDG-PET/CT in combination with bone marrow biopsy results serving as the gold standard. Regarding staging, we found that WB-DW/MRI is a feasible imaging technique. Visual image analysis sufficed to accurately detect extranodal disease, while adequate nodal characterisation required ADC calculations. Lymph node characterisation was further improved by using a more elaborate quantitative analysis based on ADC parameters derived from whole-lesion ADC histogram analysis next to the commonly used mean ADC. In the context of treatment response assessment, mean ADC changes between the baseline and interval scan performed after one cycle of (immuno)chemotherapy significantly correlated with progression-free-survival in patients with aggressive non-Hodgkin lymphoma (NHL). For Hodgkin lymphoma, taking into account the typical intralesional heterogeneity, an advanced 3-D texture analysis was performed, which demonstrated that ADC parameters associated with tumour heterogeneity (energy, local homogeneity, and entropy) were predictive of outcome in contrast to conventional ADC parameters.
(BELG J HEMATOL 2018;9(6):242–4)
Read moreBJH - volume 9, issue 5, september 2018
A. Coolbrandt , H. Wildiers , K. Milisen
The aim of this dissertation was to develop and evaluate a nursing intervention that reduces symptom burden during chemotherapy. We developed an intervention that uses motivational interviewing to support self-efficacy and to improve symptom self-management. In a quasi-experimental study in adult patients treated with chemotherapy, the intervention significantly reduced overall symptom distress and symptom severity at all three time points in the study (three, six and twelve weeks after the start of the treatment).
(BELG J HEMATOL 2018;9(5):192–4)
Read moreBJH - volume 9, issue 3, june 2018
V. Galle MD, P. Vlummens MD, F. Offner MD, PhD
Chronic lymphocytic leukaemia has a very heterogeneous disease evolution. Prognostic factors of B-CLL overall survival have been extensively studied. However, much less is known about prognostic factors that can identify patients who will never develop an indication for treatment, at the time of their initial diagnosis. In this study we give an overview of variables that have a predictive value for treatment free survival. Subsequently, we try to develop a novel prognostic index, to address the question ‘who will never need treatment for B-CLL?’.
(BELG J HEMATOL 2018;9(3):124–9)
Read moreBJH - volume 9, issue 2, march 2018
E. Vanlancker ir, PhD, B. Vanhoecke PhD, B. De Moerloose MD, PhD, T. Van de Wiele ir, PhD
In this PhD thesis, we investigated the impact of chemotherapy on the microbiota in the context of mucositis by using different experimental set-ups. Using bacterial monocultures, we showed that exposure to 5-fluorouracil at physiologically relevant concentrations differentially impacts oral microorganisms. Despite this difference in microbial sensitivity to 5-fluorouracil in pure cultures, we showed that the impact of 5-fluorouracil, as well as irinotecan, towards highly diverse gastrointestinal microbial populations is only marginal. These findings were generated with two different model systems that exclude host cells and this led us to conclude that the host is crucial in the establishment of chemotherapy-induced shifts in microbial composition and functionality. The next step in our research entailed the use of an in vitro wound healing model, where we demonstrated that the presence of microbiota negatively impacts the wound healing capacity of damaged oral epithelial cells. This indicates that microbial presence can delay the recovery from mucositis. Yet, we also found that microbial composition, which is for instance disturbed in patients receiving cancer therapy, is an additional determinant of aggravated wound healing. We further substantiated this conclusion with an in vivo longitudinal monitoring study of paediatric patients treated for haematological malignancies. While shifts in the oral microbial community during and following chemotherapy were mostly patient-specific, clear associations were made with the use of systemic antibiotics and antibacterial mouth rinses, which create microbial dysbiosis. In view of these findings we propose that the preventive use of antimicrobials needs careful consideration given the profound impact on the microbiome and subsequent consequence for the host.
(BELG J HEMATOL 2018;9(2):68–70.)
Read moreBJH - volume 8, issue 7, december 2017
S.M. Aukema MD
On May 29th, 2017, Sietse M. Aukema defended his thesis, entitled ‘Role of MYC in paediatric and adult B-cell lymphoma patients’. His research was performed under the supervision of (hemato)pathologist Prof. P.M. Kluin, MD, PhD, and clinical geneticist Prof. R. Siebert, MD. The most important findings of his thesis are summarised in this report.
(BELG J HEMATOL 2017;8(7):276–8)
Read moreBJH - volume 8, issue 6, october 2017
S. Peirs PhD
Patients with T-cell acute lymphoblastic leukaemia are mainly treated with intensive combination chemotherapy. Although this treatment strategy is quite successful in children, refractory or relapsed disease is more difficult to treat. Moreover, the chemotherapeutic agents are associated with substantial toxicity. In order to find more effective and less toxic therapies, the genetic and epigenetic alterations in T-cell acute lymphoblastic leukaemia are studied and molecularly targeted drugs are being developed. In this thesis, two new strategies to treat T-cell acute lymphoblastic leukaemia were identified and evaluated. On the one hand, high expression of the anti-apoptotic factor BCL2 was found as a hallmark of the immature T-cell acute lymphoblastic leukaemia subgroup. The BCL-2 specific inhibitor venetoclax proved to be a promising potential new therapy in T-cell acute lymphoblastic leukaemia and synergized with standard chemotherapeutic agents and BET bromodomain inhibitors. On the other hand, the enzyme KDM1A was identified as an interaction partner of the oncogenic transcription factor ZEB2. Antileukemic effects were demonstrated in several T-cell acute lymphoblastic leukaemia cell lines upon pharmacological inhibition of KDM1A.
(BELG J HEMATOL 2017;8(6):244–6)
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