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
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)
Read moreBJH - volume 15, issue 6, october 2024
K. Rack PhD, N. Van Roy PhD, P. Chiarappa PhD, J. Luciani PhD, C. Dressen PhD, S. Horion MSc, J. de Bie MD, PhD, G. Ameye MSc, J. Vanhevel PhD, L. Michaux MD, PhD, S. Beckers PhD, L. Rooms PhD, P. Heimann MD, PhD, T. Sticca PhD, M. Jamar MD, PhD, S. Toffoli PhD, MSc, C. Menten PhD, C. Lété PhD, S. Franke PhD, B. Dewaele PhD
Genomic abnormalities play an increasingly important role in prognostication and classification of haematological malignancies (HM), as evidenced by their continual integration into updated classification and risk assessment models. Optical Genome Mapping (OGM) is a relatively new high-resolution technology that offers novel opportunities to assess chromosome abnormalities, increasing the detection yield of clinically relevant abnormalities and allowing rationalisation of diagnostic pathways by abrogating the need for multiple complementary tests. Furthermore, it could streamline laboratory’s technical pipelines, avoiding the need for multiple disease specific workflows. Given these findings, OGM is currently being implemented into the diagnostic workflow, as a first line test, by numerous laboratories worldwide and is being validated with view to implementation in many more, including Belgium. Here we propose recommendations for implementation of OGM testing in the routine diagnostic workup of HM.
(BELG J HEMATOL 2024;15(6):233–7)
Read moreBJH - volume 15, issue 4, june 2024
J. Brijs MD, M. André MD, PhD, S. Bailly MD, K. Beel MD, PhD, C. Bonnet MD, G. Crochet MD, P. De Paepe MD, PhD, D. Dierickx MD, PhD, C. Jacquy MD, PhD, K. Saevels MD, S. Snauwaert MD, PhD, E. Van den Neste MD, PhD, V. Vergote MD
Diffuse large B-cell lymphoma (DLBCL) is an aggressive B-cell lymphoma and represents the most common subtype of B-cell non-Hodgkin lymphomas. The majority of patients (60–70%) can nowadays be cured with first line chemo-immunotherapy (CIT), mostly a combination of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). The remaining 30–40% of patients with relapsing or refractory (R/R) disease have an unfavourable prognosis. Until recently, these patients could only be cured with platinum-based salvage CIT followed by high-dose chemotherapy and an autologous stem cell transplantation, but with rather disappointing outcomes. However, new and promising treatments for these patients have now found their way into clinical practice, with good response and survival rates and manageable toxicity rates. This article will briefly review the latest advances in the treatment of DLBCL in Belgium, both for newly diagnosed disease and for R/R disease. We will focus on the role of polatuzumab vedotin in first line, chimeric antigen receptor (CAR) T-cell therapy in second line, tafasitamab-lenalidomide in second line or higher, and bispecific antibodies in third line or higher. New treatment algorithms, both for untreated and for R/R DLBCL, clinically oriented and adapted to the Belgian reimbursement criteria, are also presented.
(BELG J HEMATOL 2024;15(4):147–57)
Read moreBJH - volume 15, issue 4, june 2024
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
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)
Read moreBJH - 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
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)
Read moreBJH - volume 14, issue 7, november 2023
A. Janssens MD, PhD, On behalf of the BHS Lymphoproliferative Disease Committee 2023: Marc André , Christophe Bonnet , Sarah Bailly , Veerle Beckers , Dominique Bron , Rutgers Callens , Charlotte Caron , Maxim Clauwaert , Sarah Debussche , Ciel De Vriendt , Virginie De Wilde , Vanessa Delrieu , Daan Dierickx , Pierre Heimann , Jan Lemmens , Marie Maerevoet , Claire Maquet , Fulvio Massaro , Caressa Meert , Marie-Christine Ngiribacu , Fritz Offner , Juliette Rademaekers , Ornella Rizzo , Kirsten Saevels , Liesbeth Schauvliege , Sylvia Snauwaert , Joan Somja , Cécile Springael , Thomas Tousseyn , Eric Van Den Neste , Sam Vandermeeren , Sam Van Hecke , Vanessa Van Hende , Marie Vercruyssen , Vibeke Vergote , Inge Vrelust , Alice Wolfromm , Ka Lung Wu.
The Belgian Haematological Society (BHS) Lymphoproliferative disease (LPD) committee updated the existing recommendations on diagnosis, prognostic scores, best strategies for front-line and subsequent-line treatment of small lymphocytic lymphoma (SLL)/chronic lymphocytic leukaemia (CLL), according to robust new data.
(BELG J HEMATOL 2023;14(7):278–303)
Read moreBJH - volume 14, issue 4, june 2023
U. Douven MD, A. Janssens MD, PhD, G. Crochet MD, S. Bailly MD, C. Bonnet MD, C. Jacquy MD, PhD, F. Offner MD, PhD, S. Snauwaert MD, PhD, E. Van den Neste MD, PhD, M. Vercruyssen MD, D. Dierickx MD, PhD, P. Vandenberghe MD, PhD, V. Vergote MD
Approximately 30–40% of patients with diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS), will relapse or are unable to obtain a complete remission (CR) after frontline treatment. These patients have a poor prognosis and represent a therapeutic challenge. In this article, we reviewed the recent literature to update the practice guidelines of the Belgian Hematology Society (BHS) Lymphoproliferative Disease Committee for the treatment of relapsed or refractory (R/R) DLBCL. In the first part, we will focus on first relapse and the role of CAR T-cell therapy in first and second relapse. In the second part, we will focus on novel treatment options for patients with a second or higher relapse, secondary central nervous system (CNS) relapse and high-grade lymphoma.
(BELG J HEMATOL 2023;14(4):170–7)
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