Cellular Therapy in High-Risk Relapsed/Refractory Chronic Lymphocytic Leukemia and Richter Syndrome.

Despite the development of highly effective, targeted inhibitors of B-cell proliferation and anti-apoptotic pathways in chronic lymphocytic leukemia (CLL), these treatments are not curative, and many patients will develop either intolerance or resistance to these treatments. Transformation of CLL to high-grade lymphoma-the so-called Richter syndrome (RS)-remains a highly chemoimmunotherapy-resistant disease, with the transformation occurring following targeted inhibitors for CLL treatment being particularly adverse. In light of this, cellular therapy in the form of allogenic stem cell transplantation and chimeric antigen receptor T-cell therapy continues to be explored in these entities. We reviewed the current literature assessing these treatment modalities in both high-risk CLL and RS. We also discussed their current limitations and place in treatment algorithms.
Competing Interests: NA received speakers fees from Gilead and research funding from Janssen. TE received education honorarium, advisory board honorarium, and travel support from Roche; received honorarium, research support, and travel to scientific conferences from Gilead; received advisory board honorarium from KITE; received honorarium from Janssen; received honorarium and travel to scientific conferences from Abbvie; received honorarium and research funding from AstraZeneca; received advisory board honorarium and a member of trial steering committee from Loxo Oncology; received advisory board honorarium and research funding from Beigene; advisory board honorarium from Incyte; and received Advisory Board Honorarium Secura Bio. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor JR declared a past co-authorship with the author TE.
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