Follow-up after Diffuse large B-cell lymphoma in complete remission: Insights into patterns of relapse detection and survivorship burden

PhD defence by Marie Therese Lassen

Assessment Committee

Associate professor Troels Hammer, Department of Clinical Medicine, University of Copenhagen (Chairperson)
Professor Marianne Tang Severinsen, Aalborg University Hospital and Aarhus University
Dr Cecilie Essholt Kiserud, Oslo University hospital

Supervisors

Associate Professor Lars Møller Pedersen
Christoffer Johansen
Associate Professor Anne Ortved Gang
Lene Kongsgaard Nielsen
Torsten Holm Nielsen
Annika von Heymann

Department

Department of Clinical Medicine

Graduate Programme

Clinical Cancer Research

Place

Building: 9, Room: Lille Auditorium, Vestermarksvej 9, 4000 Roskilde

Email address to gain access to the thesis: marie.therese.lassen@gmail.com.
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Short description of the thesis

This PhD thesis investigates follow-up and survivorship in patients with DLBCL in complete remission after curative first-line treatment. The thesis comprises two studies. The first, a retrospective population-based study, found that 70% of relapses were detected outside scheduled follow-up, predominantly through patient-initiated contact due to symptoms, while 83% of relapses were symptomatic. Routine imaging and blood tests contributed little to relapse detection. The second, the prospective LyPRO cohort, examined survivorship using patient-reported outcomes in 228 survivors. Clinically significant fear of cancer recurrence was common, particularly shortly after treatment, with persistent FCR in a subgroup. Physical late effects were also frequent. Overall, the findings support more individualized, patient-centred follow-up integrating symptom awareness, psychological assessment, and patient-reported outcomes.