Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Norbert Schmitz, University Hospital Münster, Germany
- Second opponent: Post. Doc. Tove Wästerlid, Karolinska University Hospital,
- Third member and chair of the evaluation committee: Professor II Kristin Bjordal, University of Oslo
Chair of the Defence
Professor II Bjørn Naume, University of Oslo
Principal Supervisor
Post. Doc. Marianne Brodtkorb, University of Oslo
Summary
Lymphoma is a type of cancer that develops from lymphocytes in the lymphatic system. The most common type is diffuse large B-cell lymphoma (DLBCL). It is an aggressive disease with a median age of 70 years. Over 60% are cured with standard immuno-chemotherapy, but some molecular groups have poor survival with standard therapy, while older patients need more tailored therapy. Improved strategies for the care of these patients are needed.
In the thesis “Age-related and molecular predictive markers in diffuse large B-cell lymphoma”, Isaksen and colleagues examine how to improve tailoring of treatment for older DLBCL patients, and how to improve identification of a molecular high-risk group commonly called “double-hit” lymphoma.
With data from a large, population-based cohort (n=784) of older (≥70 years) DLBCL patients, Isaksen and colleagues developed and validated a simple frailty score that classified patients into three frailty groups that were predictive of survival and severe toxicity. The effect of treatment intensity on survival was different across the frailty groups, and this score could be a useful tool to inform treatment decisions.
Isaksen and colleagues also developed and validated a new prognostic index, the Geriatric Prognostic Index, tailored for older DLBCL patients. This index combines known risk factors in DLBCL with geriatric factors, and it outperformed standard prediction models.
Moreover, Isaksen and colleagues validated a new gene-expression assay for detection of “double-hit” lymphoma. They applied the assay to biopsies from younger DLBCL patients who had received intensified treatment in two Nordic trials. The assay identified the majority of “double-hit” patients. Further, the “double-hit” group had excellent survival. The intensive therapy might have contributed to the favorable outcome.
These results can contribute to better tailoring of treatment for older DLBCL patients and improved identification and treatment of “double-hit” lymphoma.
Additional information
Contact the research support staff.