The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
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Digital Trial Lecture - time and place
Adjudication committee
- First opponent: Professor Sigurður Yngvi Kristinsson, University of Iceland, Reykjavik
- Second opponent: Associate Professor Anders Vik, UiT The Arctic University of Norway, Tromsø
- Third member and chair of the evaluation committee: Professor II Anne Hansen Ree, Institute of Clinical Medicine, University of Oslo
Chair of defence
Professor II Inger Nina Farstad, Institute of Clinical Medicine, University of Oslo
Principal Supervisor
Professor II Geir Erland Tjønnfjord, Institute of Clinical Medicine, University of Oslo
Summary
Andrea Lenartova and collaborators studied epidemiology of chronic lymphocytic leukemia and second hematological malignancies in retrospective population-based cohort studies.
Whole-nation cohort from The Cancer Registry of Norway included 7664 patients.
CLL became more common in Norway through 1953-2012, and despite an aging population, the proportion of patients younger than 70 years increased. Diagnostic methods changed through the period and immunophenotyping became the main diagnostic method in 2003-2012, and the proportion of patients diagnosed by histology and autopsy decreased.
Survival increased, and in 2003-2012, CLL survival was close to the survival of the general Norwegian population.
Subpopulations with significantly shorter survival were identified. CLL shortened survival substantially in elderly patients. Patients acquiring second hematological malignancies, i.e. Richter syndrome (diffuse large B-cell lymphoma or Hodgkin lymphoma) and myeloid neoplasia had very short survival. Incidence rate of Richter syndrome more than doubled from 1993-2002 to 2003-2012. Richter syndrome (108 patients) occurred early, during the first years after leukemia diagnosis in both untreated and treated patients. Andrea Lenartova and collaborators study this cohort for genetic predisposition to lymphoid malignancy.
During the work with this study (2014-19), targeted therapy for CLL emerged, and the revolution in CLL treatment show promising results in both elderly and previously relapsed and refractory patients. However, the real world data for treatment with ibrutinib and venetoclax show high rates of treatment discontinuation, in many cases due to early and very aggressive Richter transformation. The knowledge and skills accumulated during this work make us competent to contribute with further surveillance for Richter syndrome, second myeloid malignancies and other possible complications appearing in the new era of CLL management.
Additional information
contact the Research Support staff