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Richter transformation in chronic lymphocytic leukemia (CLL)-a pooled analysis of German CLL Study Group (GCLLSG) front line treatment trials.
- Source :
-
Leukemia [Leukemia] 2021 Jan; Vol. 35 (1), pp. 169-176. Date of Electronic Publication: 2020 Mar 17. - Publication Year :
- 2021
-
Abstract
- Richter transformation (RT) is defined as development of aggressive lymphoma in patients (pts) with CLL. The incidence rates of RT among pts with CLL range from 2 to 10%. The aim of this analysis is to report the frequency, characteristics and outcomes of pts with RT enrolled in trials of the GCLLSG. A total of 2975 pts with advanced CLL were reviewed for incidence of RT. Clinical, laboratory, and genetic data were pooled. Time-to-event data, starting from time of CLL diagnosis, of first-line therapy or of RT diagnosis, were analyzed by Kaplan-Meier methodology. One hundred and three pts developed RT (3%): 95 pts diffuse large B-cell lymphoma (92%) and eight pts Hodgkin lymphoma (8%). Median observation time was 53 months (interquartile range 38.1-69.5). Median OS from initial CLL diagnosis for pts without RT was 167 months vs 71 months for pts with RT (HR 2.64, CI 2.09-3.33). Median OS after diagnosis of RT was 9 months. Forty-seven pts (46%) received CHOP-like regimens for RT treatment. Three pts subsequently underwent allogeneic and two pts autologous stem cell transplantation. Our findings show that within a large cohort of GCLLSG trial participants, 3% of the pts developed RT after receiving first-line chemo- or chemoimmunotherapy. This dataset confirms the ongoing poor prognosis and high mortality associated with RT.
- Subjects :
- Adult
Aged
Aged, 80 and over
Biopsy
Disease Progression
Female
Genetic Variation
Germany
Humans
Leukemia, Lymphocytic, Chronic, B-Cell genetics
Leukemia, Lymphocytic, Chronic, B-Cell therapy
Lymphoma etiology
Lymphoma mortality
Lymphoma therapy
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Prognosis
Survival Analysis
Time Factors
Young Adult
Cell Transformation, Neoplastic genetics
Leukemia, Lymphocytic, Chronic, B-Cell pathology
Lymphoma pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5551
- Volume :
- 35
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Leukemia
- Publication Type :
- Academic Journal
- Accession number :
- 32203141
- Full Text :
- https://doi.org/10.1038/s41375-020-0797-x