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Kremer group

We focus on survivorship research, epidemiological trends of childhood cancer, and quality of care improvement. We have expertise in performing large epidemiological studies on cohorts of children with cancer and survivors, performing (eHealth) interventions and implementation studies, and developing systematic reviews, guidelines and outcome indicators. Research is embedded and performed within local, national (LATER study group), and international networks, among which the pan-European PanCare network and the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG).

Group leader: Prof.dr. Leontien Kremer, pediatrician
Phone 088 97 25 192

Survivorship research

Even many years after treatment, childhood cancer survivors are at high risk of developing long-term health effects resulting from their previous cancer treatment. Our group is focusing on quantification of the role of cancer treatment and other important risk factors as they impact health and quality of life, the development, validation and implementation of prediction models and potential (eHealth) interventions.

Nationally our group collaborates with the LATER outpatient clinic, LATER central data office, and survivors. In the Netherlands, we have identified more than 12,000 5-year survivors treated for childhood cancer between 1963 and 2014. More than 6,000 of them participated in the multidisciplinary national Dutch Childhood Cancer Survivor Study 1 (DCCSS-LATER 1), which included data about childhood cancer diagnosis and treatment, health, lifestyle, and psychosocial functioning from questionnaires, and data on health outcomes from linkage to health registries. So far, 2,400 survivors participated in the DCCSS-LATER 2 study and visited the LATER outpatient clinic for additional medical data and blood sample collection. The national LATER research is unique in the world. Current research topics that we address are late mortality, burden of disease, subsequent tumors, cardiovascular toxicity, fertility, lifestyle, aging, frailty, fatigue, psychosocial health, radiation epidemiology, health care burden and evaluation of care.

We participate as a partner in the European PanCareSurFup project, with our focus on cardiac disease after treatment for childhood cancer and guideline development, including models of care and transition. In European PanCareLIFE we participate as a partner with our focus on guideline development for fertility and fertility preservation. In addition, Leontien Kremer is leading the European PanCareFollowUp study on the implementation of survivorship care in four countries and the development of an eHealth lifestyle intervention. Moreover, we perform collaborative studies with the Childhood Cancer Survivor Study, United States.

"The results of clinical research have to be included in guidelines to improve the quality of care." Prof.dr. Leontien Kremer - Group leader

Systematic reviews, guidelines and outcomes of care

Systematic reviews are of great importance in the current era of evidence-based medicine. They provide transparent and reproducible insight into the available scientific evidence for a specific question and the possible lack thereof. It thereby provides a starting point for new clinical research in pediatric oncology. Systematic reviews also form the basis for clinical practice guidelines, which are essential for the translation of scientific evidence into daily clinical practice.

Within the Princess Máxima Center for pediatric oncology, the Systematic Review & Guideline Unit provides support for both Cochrane systematic reviews and other types of systematic reviews on childhood cancer.

Furthermore, our group provides the evidence-based methodology for developing guidelines within pediatric oncology. We produce international harmonized guidelines for the long-term follow-up care for childhood cancer survivors and fertility preservation for children with cancer, and national and international supportive care guidelines. Moreover, we focus on developing outcome indicators to measure the quality of care. Leontien Kremer is the founder and co-chair of the IGHG, together with Melissa Hudson from the St. Jude Children’s Research Hospital, Memphis, United States.

Handbook systemic reviews PMC
Handbook guidelines IGHG

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Kremer group