PhD defence L. (Lina) van der Straten

Brief summary:

Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the Western world. Over the past decades, our understanding of CLL has significantly advanced, leading to improvements in diagnostics, novel treatments, and better patient outcomes. However, most of these advancements stem from randomized controlled trials involving select patient populations, which may not fully represent everyday clinical practice. This highlights the need for population-based registries to assess the general effectiveness of treatments, especially in older patients with comorbidities.

This thesis utilizes data from the Netherlands Cancer Registry to examine trends in CLL epidemiology, including incidence and survival estimates (part I), and the effectiveness of various therapeutic strategies in molecular subgroups of CLL patients. Additionally, it explores alternative clinical endpoints such as adverse events, geriatric impairments, and quality of life, with a particular focus on older, frail patients. Given the improvement in CLL longevity, this thesis also investigates long-term complications, including second primary malignancies, Richter transformation, and causes of death (part III).

Overall, this thesis provides a comprehensive overview of the epidemiology and molecular aspects of CLL from diagnosis to death, encapsulating the lifelong journey of CLL patients and offering valuable insights to guide future clinical practice.