PhD defence M. (Matthijs) van der Meulen

A primary central nervous system lymphoma in a rare form of non-Hodgkin lymphoma that occurs only in the brain, without disease activity in the rest of the body. The disease is increasingly common among people over 60, but remains rare with only about 70 new patients per year in the Netherlands. The prognosis has improved significantly in recent years. 

Diagnosis can be made by viewing a biopsy under the microscope. We showed that if you also examine the biopsy with the flow cytometry, you often make the diagnosis within <24 hours.

After treatment, the effect of the treatment is measured in a so-called response evaluation. Obviously, the prognosis is poor if there is no response to treatment. However, we showed that the to what extent the response was does not influence survival. 

The addition of rituximab to standard chemotherapy regimen is no better than chemotherapy alone. Cognitive functioning and quality of life improved after treatment, but was similar in patients treated with and without rituximab. 
Patients under 60 years of age also received radiation to the skull, after chemotherapy. In contrast to previous research, the cognitive functioning of these patients remained stable up to 2 years after radiation. 

Prognosis is often determined by age and condition at the start of treatment. Cognition, measured with the screening tool: Mini-Mental State Examination (MMSE) was found to be the only predictor of survival in our patient group.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall or in the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.