Allogeneic Hematopoietic Cell Transplantation for Richter Syndrome: A Single-Center Experience

Abstract

Allogeneic hematopoietic cell transplantation is an effective treatment for patients with Richter syndrome who show an objective response before allografting. Patients must be referred to transplant centers as soon as the diagnosis is confirmed to evaluate candidacy for the procedure and identify a suitable donor in a timely manner.

NCCN Guidelines Insights: Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, Version 2.2019

“…Chronic Lymphocytic Leukemia/ Small Lymphocytic Lymphoma, Version 2.2019 Allogeneic hematopoietic cell transplant (alloHCT) can be considered for patients with disease responding to initial chemoimmunotherapy. 6,34,35 In a nonrandomized comparative analysis, the estimated cumulative 3-year survival rate was significantly higher (75%) for patients who underwent alloHCT after achieving a CR or PR to initial therapy compared with those who responded to initial therapy but did not undergo alloHCT, or who underwent alloHCT for relapsed or refractory Richter's transformation (75% vs 27% and 21%, respectively; P=.019). 6 In a retrospective analysis that evaluated the outcome after autologous HCT or alloHCT in 59 patients with Richter's transformation, the 3-year estimated OS, relapse-free survival, and cumulative incidences of relapse and nonrelapse mortality rates were 36%, 27%, 47%, and 26%, respectively, for alloHCT, and 59%, 45%, 43%, and 12%, respectively, for autologous HCT.…”

Current Trends in the Management of Richter’s Syndrome

“…Which type of transplant, autologous (auto-) versus allogeneic (allo-), can be debated, but the majority of data suggest that allotransplant likely provides the best opportunity for durable remissions should a patient be able to achieve a deep remission with induction chemotherapy. The impact of transplant on RS has been best summarized by three recent retrospective studies [25,64,65]. In 2006, Tsimberidou reported 20 patients who underwent stem cell transplantation (SCT).…”

Allogeneic hematopoietic cell transplantation outcomes in patients with Richter’s transformation

“…Graft-versus-leukemia (GVL) activity after allogeneic hematopoietic cell transplantation (alloHCT) is evident in patients with CLL where durable remissions can be achieved in all genetically defined high-risk subsets [7][8] . Indeed, several small studies have reported benefit from alloHCT in RT [9][10][11] . To better understand the therapeutic value of alloHCT in the modern era, we report alloHCT outcomes for 28 consecutive patients with RT who received chemoimmunotherapy and/or targeted therapy prior to alloHCT.…”