Publications of Christophe BONNET
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See detailDual-tracer PET/CT scan after injection of combined [ 18 F]NaF and [ 18 F]FDG outperforms MRI in the detection of myeloma lesions
WITHOFS, Nadia ULiege; Beguin, Yves ULiege; COUSIN, François ULiege et al

in Hematological Oncology (2019), 37

The detection rates of whole-body combined [ 18 F]NaF/[ 18 F]FDG positron emission tomography combined with computed tomography (PET/CT), CT alone, whole-body magnetic resonance imaging (WB-MRI), and X ... [more ▼]

The detection rates of whole-body combined [ 18 F]NaF/[ 18 F]FDG positron emission tomography combined with computed tomography (PET/CT), CT alone, whole-body magnetic resonance imaging (WB-MRI), and X-ray were prospectively studied in patients with treatment-requiring plasma cell disorders The detection rates of imaging techniques were compared, and focal lesions were classified according to their anatomic location. Twenty-six out of 30 initially included patients were assessable. The number of focal lesions detected in newly diagnosed patients (n = 13) and in relapsed patients (n = 13) were 296 and 234, respectively. The detection rate of PET/CT was significantly higher than those of WB-MRI (P < 0.05) and CT (P < 0.0001) both in patients with newly diagnosed and in those with relapsed multiple myeloma (MM). The X-ray detection rate was significantly lower than those of all other techniques, while CT detected more lesions compared with WB-MRI at diagnosis (P = 0.025). With regard to the infiltration patters, relapsed patients presented more diffuse patterns, and more focal lesions located in the limbs compared with newly diagnosed patients. In conclusion, the detection rate of [ 18 F]NaF/[ 18 F]FDG PET/CT was significantly higher than those of CT, MRI, and X-ray, while the detection rate of X-rays was significantly lower than those of all other imaging techniques except for focal lesions located in the skull. © 2019 John Wiley & Sons, Ltd. [less ▲]

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See detailObinutuzumab plus Lenalidomide (GALEN) for the treatment of relapse/refractory aggressive lymphoma: a phase II LYSA study
Houot, Roch; Cartron, Guillaume; Bijou, Fontanet et al

in Leukemia (2019), 33

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See detailCentral nervous system relapse in patients over 80 years with diffuse large B-cell lymphoma: an analysis of two LYSA studies
Cabannes-Hamy, A.; Peyrade, F.; Jardin, F. et al

in Cancer Medicine (2018)

CNS relapse is reported in 2–5% of diffuse large B-cell lymphoma (DLBCL) patients, dramatically decreasing overall survival (OS). Very few studies address incidence and risk factors of CNS relapse in very ... [more ▼]

CNS relapse is reported in 2–5% of diffuse large B-cell lymphoma (DLBCL) patients, dramatically decreasing overall survival (OS). Very few studies address incidence and risk factors of CNS relapse in very elderly patients, a challenging population to treat given their commonly associated comorbidities. A retrospec-tive analysis was performed of 270 DLBCL patients >80years treated between 2004 and 2013 in two multicentre phase II LYSA trials (LNH03-7B, LNH09-7B) evaluating the addition of rituximab or ofatumumab to mini-CHOP as front-line therapy. No patients received CNS prophylaxis. CNS relapse was evaluated according to cumulative incidence, patient characteristics, risk factors, and sur-vival. Median age was 83years (range: 79–95). After a median follow-up of 28.7months, eight patients had CNS relapse (3.0%). Median time between inclusion and CNS relapse was 19.2months (range: 3.2–32.6). Patients survived a median of 1.5months after CNS relapse (range: 0.4–4.1). Median OS from relapse was significantly lower in CNS relapse patients (1.5months, 95% CI: 0.4–3.5) compared to patients with non-CNS relapse (6.6months; 95% CI: 4.6–11.9). No baseline characteristics were associated with CNS relapse. The proportion of patients with CNS disease did not differ significantly between patients with low- intermediate risk according to CNS- IPI and patients with high risk (3% vs. 2.8%, P = 1.00). CNS relapse cumulative incidence in very elderly treatment- naive patients is 1.8% at 2 years and is associated with poor survival. This population had a long median time to CNS relapse. Absence of prophylaxis did not strongly impact CNS relapse incidence. [less ▲]

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See detailRole of up-front autologous stem cell transplantation in peripheral T-cell lymphoma for patients in response after induction: An analysis of patients from LYSA centers.
Fossard, Gaëlle; Broussais, Florence; Coelho, Inês et al

in Annals of Oncology (2018), 29

Background: Peripheral T-cell lymphoma (PTCL) remains a therapeutic challenge. Due to the rarity and the heterogeneity of PTCL, no consensus has been achieved regarding even the type of first-line ... [more ▼]

Background: Peripheral T-cell lymphoma (PTCL) remains a therapeutic challenge. Due to the rarity and the heterogeneity of PTCL, no consensus has been achieved regarding even the type of first-line treatment. The benefit of autologous stem-cell transplantation (ASCT) is, therefore, still intensely debated. Patients and methods: In the absence of randomized trials addressing the role of ASCT, we performed a large multicentric retrospective study and used both a multivariate proportional hazard model and a propensity score matching approach to correct for sample selection bias between patients allocated or not to ASCT in intention-to-treat (ITT). Results: Among 527 patients screened from 14 centers in France, Belgium and Portugal, a final cohort of 269 patients 65 years old with PTCL-not otherwise specified (NOS) (N¼78, 29%), angioimmunoblastic T-cell lymphoma (AITL) (N¼123, 46%) and anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK-ALCL) (N¼68, 25%) with partial (N¼52, 19%) or complete responses (N¼217, 81%) after induction was identified and information about treatment allocation was carefully collected before therapy initiation from medical records. One hundred and thirty-four patients were allocated to ASCT in ITT and 135 were not. Neither the Cox multivariate model (HR¼1.02; 95% CI: 0.69–1.50 for PFS and HR¼1.08; 95% CI: 0.68– 1.69 for OS) nor the propensity score analysis after stringent matching for potential confounding factors (logrank P¼0.90 and 0.66 for PFS and OS, respectively) found a survival advantage in favor of ASCT as a consolidation procedure for patients in response after induction. Subgroup analyses did not reveal any further difference for patients according to response status, stage disease or risk category. Conclusions: The present data do not support the use of ASCT for up-front consolidation for all patients with PTCL-NOS, AITL, or ALK-ALCL with partial or complete response after induction. [less ▲]

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See detailPredictive value of PET response combined with baseline metabolic tumor volume in peripheral T-cell lymphoma patients
FOSSARD, G; BROUSSAIS, F; COELHO, I et al

in European Journal of Nuclear Medicine (2018), 59

Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive non-Hodgkin lymphomas with poor outcomes on current therapy. We investigated whether response assessed with PET/CT combined with ... [more ▼]

Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive non-Hodgkin lymphomas with poor outcomes on current therapy. We investigated whether response assessed with PET/CT combined with baseline total metabolic tumor volume (TMTV) could detect early relapse or refractory disease. Methods: From 7 European centers, 140 patients with nodal PTCL who underwent baseline PET/CT were selected. Forty-three had interim PET (iPET) performed after 2 cycles (iPET2), 95 had iPET performed after 3 or 4 cycles (iPET3/4), and 96 had end-of-treatment PET (eotPET). Baseline TMTV was computed with a 41% SUVmax threshold, and PET response was reported using the Deauville 5-point scale. Results: With a median of 43 mo of follow-up, the 2-y progression-free survival (PFS) and overall survival (OS) were 51% and 67%, respectively. iPET2-positive patients (Deauville score ≥ 4) had a significantly worse outcome than iPET2-negative patients (P < 0.0001, hazard ratio of 6.8 for PFS; P < 0.0001, hazard ratio of 6.6 for OS). The value of iPET3/4 was also confirmed for PFS (P < 0.0001) and OS (P < 0.0001). The 2-y PFS and OS for iPET3/4-positive (n = 28) and iPET3/4-negative (n = 67) patients were 16% and 32% versus 75% and 85%, respectively. The eotPET results also reflected patient outcome. A model combining TMTV and iPET3/4 stratified the population into distinct risk groups (TMTV ≤ 230 cm3 and iPET3/4-negative [2-y PFS/OS, 79%/85%]; TMTV > 230 cm3 and iPET3/4-negative [59%/84%]; TMTV ≤ 230 cm3 and iPET3/4-positive [42%/50%]; TMTV > 230 cm3 and iPET3/4-positive [0%/18%]). Conclusion: iPET response is predictive of outcome and allows early detection of high-risk PTCL patients. Combining iPET with TMTV improves risk stratification in individual patients. [less ▲]

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See detailResults from the Belgian mantle cell lymphoma registry
Vergote, Vibeke; Janssens, Ann; André, Marc et al

in Acta Clinica Belgica (2017), 38

Introduction: Mantle cell lymphoma is a B-cell non-Hodgkin’s lymphoma characterized by a t(11;14), resulting in overexpression of cyclin D1. Conventional chemotherapy obtains frequent (but short ... [more ▼]

Introduction: Mantle cell lymphoma is a B-cell non-Hodgkin’s lymphoma characterized by a t(11;14), resulting in overexpression of cyclin D1. Conventional chemotherapy obtains frequent (but short) remissions, leading to a poor median overall survival (OS) of 3–5 years. To obtain more information about the prevalence and current treatment of Mantle cell lymphoma (MCL) in Belgium, we collected data in a Belgian registry of MCL. Materials and methods: All Belgian MCL patients, t(11;14) and/or cyclin D1 positive, seen in hematology departments over a one-year period (April 2013–March 2014) were included. Data about patient characteristics, histology, treatment lines, and response were compiled and retrospectively analyzed. Results: Four hundred and four patients were included with a median age at diagnosis of 64 years (range 23–96 years) and a male predominance (72%). For 2013, we calculated a prevalence of at least 36.2 per million and an incidence of at least 7.0 per million in the Belgian population. Characteristics at diagnosis involved lymphadenopathy (82%), splenomegaly (44%), B-symptoms (39%), and hepatomegaly (10%). Bone marrow invasion was present at diagnosis in 77%. Stage at diagnosis was advanced in the majority of cases. The median number of treatment lines was 1. Type of first line treatment included a combination of anthracyclin and cytarabinebased regimen (34%), anthracyclin (39%), and other. Rituximab was used in 88% of first line treatments. In 44% first line treatment was followed by autologous stem cell transplantation. Conclusion: The analysis of this Belgian MCL registry provides insight in the epidemiology, demographics, and current treatment of our Belgian MCL population. [less ▲]

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See detailA First Report on [(18)F]FPRGD2 PET/CT Imaging in Multiple Myeloma.
WITHOFS, Nadia ULiege; COUSIN, François ULiege; DE PRIJCK, Bernard ULiege et al

in Contrast Media and Molecular Imaging (2017), 2017

An observational study was set up to assess the feasibility of [(18)F]FPRGD2 PET/CT for imaging patients with multiple myeloma (MM) and to compare its detection rate with low dose CT alone and combined ... [more ▼]

An observational study was set up to assess the feasibility of [(18)F]FPRGD2 PET/CT for imaging patients with multiple myeloma (MM) and to compare its detection rate with low dose CT alone and combined [(18)F]NaF/[(18)F]FDG PET/CT images. Four patients (2 newly diagnosed patients and 2 with relapsed MM) were included and underwent whole-body PET/CT after injection of [(18)F]FPRGD2. The obtained images were compared with results of low dose CT and already available results of a combined [(18)F]NaF/[(18)F]FDG PET/CT. In total, 81 focal lesions (FLs) were detected with PET/CT and an underlying bone destruction or fracture was seen in 72 (89%) or 8 (10%) FLs, respectively. Fewer FLs (54%) were detected by [(18)F]FPRGD2 PET/CT compared to low dose CT (98%) or [(18)F]NaF/[(18)F]FDG PET/CT (70%) and all FLs detected with [(18)F]FPRGD2 PET were associated with an underlying bone lesion. In one newly diagnosed patient, more [(18)F]FPRGD2 positive lesions were seen than [(18)F]NaF/[(18)F]FDG positive lesions. This study suggests that [(18)F]FPRGD2 PET/CT might be less useful for the detection of myeloma lesions in patients with advanced disease as all FLs with [(18)F]FPRGD2 uptake were already detected with CT alone. [less ▲]

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See detailUnmet needs in the scientific approach to older patients with lymphoma
Bron, D.; Aurer, I.; André, Marine ULiege et al

in Haematologica (2017), 102(6), 972-975

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See detailActivating mutations in genes related to TCR signaling in angioimmunoblastic and other follicular helper T-cell–derived lymphomas
Vallois, David; Dobay, Maria Pamela D.; Morin, Ryan D. et al

in Blood (2016), 128

Angioimmunoblastic T-cell lymphoma (AITL) and other lymphomas derived from follicular T-helper cells (TFH) represent a large proportion of peripheral T-cell lymphomas (PTCLs) with poorly understood ... [more ▼]

Angioimmunoblastic T-cell lymphoma (AITL) and other lymphomas derived from follicular T-helper cells (TFH) represent a large proportion of peripheral T-cell lymphomas (PTCLs) with poorly understood pathogenesis and unfavorable treatment results. We investigated a series of 85 patients with AITL (n 5 72) or other TFH-derived PTCL (n 5 13) by targeted deep sequencing of a gene panel enriched in T-cell receptor (TCR) signaling elements. RHOA mutations were identified in 51 of 85 cases (60%) consisting of the highly recurrent dominant negative G17V variant in most cases and a novel K18N in 3 cases, the latter showing activating properties in in vitro assays. Moreover, half of the patients carried virtually mutually exclusive mutations in other TCR-related genes, most frequently in PLCG1 (14.1%), CD28 (9.4%, exclusively in AITL), PI3K elements (7%), CTNNB1 (6%), and GTF2I (6%). Using in vitro assays in transfected cells, we demonstrated that 9 of 10 PLCG1 and 3 of 3 CARD11 variants induced MALT1 protease activity and increased transcription from NFAT or NF-kB response element reporters, respectively. Collectively, the vast majority of variants in TCR-related genes could be classified as gain-of-function. Accordingly, the samples with mutations in TCR-related genes other than RHOA had transcriptomic profiles enriched in signatures reflecting higher T-cell activation. Although no correlationwithpresenting clinical featuresnor significantimpacton survivalwasobserved, thepresenceofTCR-relatedmutations correlated with early disease progression. Thus, targeting of TCR-related eventsmay hold promise for the treatment of TFH-derived lymphomas. [less ▲]

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See detailComparison of combined whole-body 18F-NAF and 18F-FDG PET/CT versus MRI for the detection of myeloma lesions
WITHOFS, Nadia ULiege; COUSIN, François ULiege; TANCREDI, Tino ULiege et al

Conference (2016, June 14)

Objectives Imaging requirements for the diagnosis of multiple myeloma (MM) recently changed and 蠅 1 osteolytic bone destruction (蠅 5 mm in size) seen on whole-body (WB) low-dose computed tomography (ldCT ... [more ▼]

Objectives Imaging requirements for the diagnosis of multiple myeloma (MM) recently changed and 蠅 1 osteolytic bone destruction (蠅 5 mm in size) seen on whole-body (WB) low-dose computed tomography (ldCT) or positron emission tomography combined with CT (PET/CT) does fulfill the criteria for bone disease. The present work assessed the lesion detection rate of WB combined [18F]NaF and [18F]FDG PET/CT versus ldCT alone and MRI in patients with newly diagnosed MM. Methods Patients with newly diagnosed MM, prospectively included, underwent WB (from vertex to toes) XR, MRI and combined [18F]NaF and [18F]FDG PET/CT (median delay between scans: 6 days). PET/CT scans were acquired after injection of 134 ± 13 MBq [18F]NaF and 249 ± 18 MBq [18F]FDG (median uptake time: 64 min). The ldCT (3 mm slice thickness; 120 kV; 50-80 mAs) followed by PET emission scan (90 seconds per bed position) were performed. The MR images were acquired in coronal planes in T1-weighted and T2-weighted short-tau inversion recovery. Diffusion-weighted with background suppression images were acquired in the axial plane and reconstructed on coronal planes. PET and LdCT images were reviewed by 2 experienced nuclear medicine physicians and 1 radiologist to detect focal lesions (FLs) and/or diffuse bone marrow involvement. The focal areas of visually detectable increased tracers’ uptake were considered as PET FLs. The MR, ldCT alone and XR images were analyzed by 3 radiologists blinded to each other and to PET/CT results. The FLs were classified according to their location: pelvis, skull, limbs, spine, ribs and one location including the sternum, scapula and clavicles. The McNemar’s test was used to compare the detection rate of each technique and the Kruskal-Wallis test was used to estimate a relationship between the detection rate and the size of FLs measured with ldCT. Results Out of 14 patients initially included, two were excluded (one for a delay > 40 days with XR and one who experienced claustrophobia during MRI acquisition). Twelve myeloma patients (median age 64y) with stage 1 (n = 4), 2 (n = 5) or 3 (n = 3) were included in the analyses. The pattern of bone marrow involvement was focal (n = 7) or combined diffuse and focal (n = 5). Per patient, 1-3 FL (n = 4), 4-10 FLs (n = 2) or > 10 FLs (n = 6) were detected. The total number of FLs detected was 281; no extramedullary disease was detected. The detection rate of MM lesions between techniques was significantly different (p < 0.05): XR (89; 32%) < PET (158; 56%) < MRI (183, 65%) < LdCT alone (219; 78%) < PET/CT (277; 99%). Out of 158 FLs detected with PET, 125 (79%) were also detected with MRI. Out of 183 MM lesions detected with MRI, 125 (68%) were detected with PET; PET positivity was significantly associated with lesion size (p = 0.002). Out of 145 FLs (蠅 5 mm) detected with ldCT, the detection rate of MRI (n = 87; 60%) and PET (n = 96; 66%) was similar (p = 0.17) and significantly associated with lesion size only for MRI (p = 0.014). Whatever FLs location, the detection rate of PET and MRI was similar except for rib MM lesions for which PET was superior to MRI (p = 0.0005). Seventeen osteolytic rib lesions detected with PET were not detected with MRI, of which only one corresponded to a pathologic fracture. At the patient’s level, the diagnosis of MM was based on biological data in 7/12 patients. For the 5 remaining patients, MM diagnosis required imaging. PET/CT and ldCT alone correctly identified bone involvement in all 5 patients; MRI would have missed the correct MM diagnosis in 3 patients (2 with diffuse pattern only and one with 1 FL); WBXR would have missed MM diagnosis in 1/5 patient (one pelvic FL missed). Conclusions The MM lesion detection rate of PET/CT was superior to ldCT alone and MRI, respectively. At the patient’s level, the accuracy of PET/CT and CT alone was superior to MRI and WB-XR for the diagnosis of MM. [less ▲]

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See detailBHS guidelines for the treatment of large granular lymphocyte and cronic prolymphocytic leukaemias
Springael, C.; Delrieu, V.; Wu, K.L. et al

in Belgian Journal of Hematology (2016), 7

Large granular lymphocyte and prolymphocytic leukaemias are rare chronic lymphoproliferative disorders. Large granular lymphocyte leukaemias consist of indolent disorders such as T-cell large granular ... [more ▼]

Large granular lymphocyte and prolymphocytic leukaemias are rare chronic lymphoproliferative disorders. Large granular lymphocyte leukaemias consist of indolent disorders such as T-cell large granular lymphocyte and chronic lymphoproliferative disorder of natural killer cells and the very rare but aggressive natural killer cell leukaemia. Treatment of the indolent large granular lymphocyte leukaemias is necessary in case of symptomatic cytopaenias or non-haematological autoimmune disorders. First line therapy of these two disorders is based on three immunosuppressive drugs: methotrexate, cyclophosphamide and cyclosporine A. Aggressive natural killer cell leukaemia needs an L-asparaginase containing regimen as induction followed by allogeneic stem cell transplantation to prolong remission. T-cell prolymphocytic leukaemia always follows an aggressive course even after an indolent onset. The optimal treatment strategy should exist of remission induction with alemtuzumab intravenously followed by autologous or allogeneic stem cell transplantation. Treatment indications for B-cell prolymphocytic leukaemia follow the criteria described by the chronic lymphocytic leukaemia guidelines. After induction with fludarabine, cyclophosphamide, rituximab or bendamustine in patients without a p53 mutation and/or a 17p deletion and alemtuzumab in case of a p53 mutation and/or a 17p deletion, stem cell transplantation must be considered. [less ▲]

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See detailLa prise en charge du lymphome chez le patient âgé
Bonnet, Christophe ULiege

Conference (2016, May)

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See detailPrognostic value of baseline total metabolic tumor volume (TMTV0) measured on FDG-PET/CT in patients with peripheral T-cell lymphoma (PTCL)†
Cottereau, A.S.; Becker, S.; Broussais, F. et al

in Annals of Oncology (2016), 27

Background: Most peripheral T-cell lymphoma (PTCL) patients have a poor outcome and the identification of prognostic factors at diagnosis is needed. Patients and methods: The prognostic impact of total ... [more ▼]

Background: Most peripheral T-cell lymphoma (PTCL) patients have a poor outcome and the identification of prognostic factors at diagnosis is needed. Patients and methods: The prognostic impact of total metabolic tumor volume (TMTV0), measured on baseline [18F] <br />2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography, was evaluated in a retrospective study including 108 PTCL patients (27 PTCL not otherwise specified, 43 angioimmunoblastic T-cell lymphomas and 38 anaplastic large-cell lymphomas). All received anthracycline-based chemotherapy. TMTV0 was computed with the 41% maximum standardized uptake value threshold method and an optimal cut-off point for binary outcomes was determined and compared with others prognostic factors. <br />Results: With a median follow-up of 23 months, 2-year progression-free survival (PFS) was 49% and 2-year overall survival (OS) was 67%. High TMTV0 was significantly associated with a worse prognosis. At 2 years, PFS was 26% in patients with a high TMTV0 (>230 cm3, n = 53) versus 71% for those with a low TMTV0, [P < 0.0001, hazard ratio (HR) = 4], whereas OS was 50% versus 80%, respectively, (P = 0.0005, HR = 3.1). In multivariate analysis, TMTV0 was the only significant independent parameter for both PFS and OS. TMTV0, combined with PIT, discriminated even better than TMTV0 alone, patients with an adverse outcome (TMTV0 >230 cm3 and PIT >1, n = 33,) from those with good prognosis (TMTV0 ≤230 cm3 and PIT ≤1, <br />n = 40): 19% versus 73% 2-year PFS (P < 0.0001) and 43% versus 81% 2-year OS, respectively (P = 0.0002). Thirty-one patients (other TMTV0–PIT combinations) had an intermediate outcome, 50% 2-year PFS and 68% 2-year OS. <br />Conclusion: TMTV0 appears as an independent predictor of PTCL outcome. Combined with PIT, it could identify different risk categories at diagnosis and warrants further validation as a prognostic marker. [less ▲]

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See detailPrimary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies
Pilorge, Sylvain; Harel, Stephanie; Ribrag, Vincent et al

in Leukemia and Lymphoma (2016), 57

Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is a rare DLBCL location variant. We treated 76 PB-DLBCL patients by immuno-chemotherapy, resulting in an 84% sustained complete remission rate and a ... [more ▼]

Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is a rare DLBCL location variant. We treated 76 PB-DLBCL patients by immuno-chemotherapy, resulting in an 84% sustained complete remission rate and a 78.9% survival over a 4.7-year median follow-up period. Ann Arbor stage IV and high age-adjusted international prognostic index were predictive of adverse outcome in univariate analysis. In multivariate analysis using a Cox model, only aa-IPI predicted long-term survival. While based on a limited number of cases, we suggested that radiotherapy may be useful as a consolidation modality in PB-DLBCL. We also suggested that positron emission tomography/CT scan should be interpreted with caution due to a persistent [18F]fluorodeoxyglucose [18FDG] uptake of bone lesions even after remission in some in PB-DLBCL patients. Our study based on a homogeneous cohort of PB-DLBCL patients confirmed the favorable outcome of this DLBCL variant and support the implementation of prospective clinical trials in this disease. [less ▲]

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See detailHighlights of the 13th International Conference on Malignant Lymphoma
BONNET, Christophe ULiege; BOSLY, A.

in Belgian Journal of Hematology (2015), 6(4), 173-178

A lot of interesting data were presented at the 13th International Conference on Malignant Lymphoma in Lugano, Switzerland. The authors summarise below those presentations/abstracts they found relevant ... [more ▼]

A lot of interesting data were presented at the 13th International Conference on Malignant Lymphoma in Lugano, Switzerland. The authors summarise below those presentations/abstracts they found relevant for daily practice, either now or in the near future. [less ▲]

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See detailWaldenström's macroglobulinaemia: Belgian Hematology Society guidelines
VAN HENDE, V.; BRON, D.; VAN DEN NESTE, E. et al

in Belgian Journal of Hematology (2015), 6(4), 142-151

Waldenström’s macroglobulinaemia is a B-cell disorder characterised by bone marrow infiltration with lymphoplasmacytic cells, along with demonstration of an IgM monoclonal gammopathy in the blood. This ... [more ▼]

Waldenström’s macroglobulinaemia is a B-cell disorder characterised by bone marrow infiltration with lymphoplasmacytic cells, along with demonstration of an IgM monoclonal gammopathy in the blood. This condition belongs to the lymphoplasmacytic lymphomas as defined by the World Health Organization classification (ICD-0 code 9671/3). Approximately one-fourth of patients are asymptomatic. Clinical features of the symptomatic patients are diverse and may relate to overall disease burden (such as peripheral blood cytopaenias, organomegaly and constitutional symptoms) or may be directly attributable to the IgM paraprotein. The latter include hyperviscosity syndrome, amyloidosis, peripheral neuropathy and cold haemagglutinin. Therapeutic options have traditionally involved alkylating agents, nucleoside analogues, and rituximab, either as single therapy or in combination. However, emerging new data on combination therapy as well as novel agents have shown encouraging results. This report provides the Belgian Hematology Society guidelines according to recent clinical studies. [less ▲]

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See detailErythropoietin therapy after allogeneic hematopoietic cell transplantation has no impact on long-term survival
JASPERS, Aurélie ULiege; Baron, Frédéric ULiege; SERVAIS, Sophie ULiege et al

in American Journal of Hematology (2015), 90(9), 197-199

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See detailLong-term safety follow-up of a randomized trial of darbepoetin alpha and intravenous iron following autologous hematopoietic cell transplantation.
JASPERS, Aurélie ULiege; Baron, Frédéric ULiege; Maertens, Johan et al

in American Journal of Hematology (2015), 90(7), 133-4

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See detailHaemolytic crisis induced by rasburicase administration revealing G-6-PD deficiency
SID, Sélim ULiege; Dugauquier, Christophe; DE PRIJCK, Bernard ULiege et al

in Belgian Journal of Hematology (2015), 6(2), 74-78

We present a patient with Burkitt's lymphoma who suffered a severe haemolytic crisis after treatment with rasburicase. This case report underlines the high incidence of glucose-6-phosphate dehydrogenase ... [more ▼]

We present a patient with Burkitt's lymphoma who suffered a severe haemolytic crisis after treatment with rasburicase. This case report underlines the high incidence of glucose-6-phosphate dehydrogenase deficiency in some ethnic groups and the importance of a detailed patient and family history before starting treatment, even in case of emergency. Glucose-6-phosphate dehydrogenase is an essential enzyme since it makes the synthesis of NADPH + H from NADP possible, which determines the reducing power (NADPH) of the cell. Every defect in this physiological process, notably glucose-6-phosphate dehydrogenase deficiency, may thus result simultaneously with the use of rasburicase in acute or chronic haemolysis according to the importance of the deficiency. Management is based on stopping the incriminated drug and on supportive therapy consisting of administering packed red blood cells if the anaemia is poorly tolerated. [less ▲]

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