Richter transformation in chronic lymphocytic leukemia (CLL)—a pooled analysis of German CLL Study Group (GCLLSG) front line treatment trials

医学 化学免疫疗法 内科学 慢性淋巴细胞白血病 四分位间距 美罗华 氟达拉滨 滤泡性淋巴瘤 IGHV@ 临床试验 入射(几何) 随访中值 胃肠病学 外科 肿瘤科 淋巴瘤 白血病 环磷酰胺 化疗 物理 光学
作者
Othman Al‐Sawaf,Sandra Robrecht,Jasmin Bahlo,Anna‐Maria Fink,Paula Cramer,Julia von Tresckow,Elisabeth Lange,Michael Kiehl,Martin Dreyling,Matthias Ritgen,Jan Dürig,Eugen Tausch,Christof Schneider,Stephan Stilgenbauer,C.‐M. Wendtner,Kirsten Fischer,Goede,Michael Hallek,Barbara Eichhorst
出处
期刊:Leukemia [Springer Nature]
卷期号:35 (1): 169-176 被引量:71
标识
DOI:10.1038/s41375-020-0797-x
摘要

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.
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