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Leontien Kremer: 'Expert knowledge of late health problems improves treatment'

Clinical Director Prof. Dr. Leontien Kremer conducts scientific research at the Princess Máxima Center. Her research group studies late health problems in childhood cancer survivors. “My dream is for parents, children, survivors and doctors to see our knowledge at the touch of a button. So they can make the best decisions together.”
In 2001 pediatrician Leontien Kremer obtained her PhD on heart damage after childhood cancer. She soon threw herself into science. Interesting work, she says, because pediatric oncology really is about something. It is important to translate knowledge effectively into practice, allowing doctors and other healthcare professionals to improve care. The Princess Máxima Center is pre-eminently a place where that is possible. After all, the doctors and researchers here work together in one building.

Improving care
The research that Kremer and her team conduct is about LATER: the professional term for late health problems caused by the disease itself or by treatment. “Expert knowledge of this allows us to improve care, both during and after treatment. In 2008 we as doctors, scientists and psychologists, together with survivors, thought about what knowledge is needed for the best care. Together we then set up the LATER study. The data of about 6,000 people who had cancer as a child is stored in a database. This includes information about their illness, their treatment and the results of questionnaires about how they are doing. A large group of survivors has been invited to participate in scientific research in addition to LATER care. About 2,500 people came to the outpatient clinic for things such as a cardiogram or a bone scan. And to talk about how they feel and what problems they’re experiencing.”

Better prediction
In the coming years all this data will be analyzed by young scientists in various projects for their doctorates. Kremer says, “This yields a considerable amount of knowledge. Consider heart failure, one of the common health problems. We already knew that a lower dose of chemotherapy helps prevent heart problems. Now we hope to discover through even more research which children are particularly at risk of later heart problems. The better you can predict that, the more precise the treatment can become.”

Decide together
When she became a professor in 2018, Kremer said in the Trouw newspaper: “Good care for children can only be given if parents have a say in the treatment.” This starting point is especially important in pediatric oncology, she explains. “We know, for example, that some chemotherapeutic agents have certain side effects in the long term. If there is room for this in the treatment, you want to allow children and parents to decide for themselves as much as possible, partly on the basis of knowledge of possible side effects. My dream is for LATER knowledge to be available to doctors, parents, patients and childhood cancer survivors at the push of a button. This would make it possible to choose the most appropriate treatment together.”

More information
Clinical Director Prof. Dr. Leontien Kremer is principal investigator (PI) of LATER and research leader at the Máxima. In addition, she is professor of Appropriate Care in Pediatrics at the University.