Partially successful treatment of a patient with chronic lymphocytic leukemia and Hodgkin's disease: Case report and literature review

Adiga, Giridhar U.; Abebe, Lool; Wiernik, Peter H.

doi:10.1002/ajh.10300

Cited by 24 publications

(19 citation statements)

References 28 publications

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“…A correlation between EBV positivity and history of Fludarabine treatment was noted, identifying the associated immune suppression as a risk factor(5, 6, 13, 14). However, EBV-negative cases are not uncommon(1, 2, 8, 15, 16).…”

Section: Introductionmentioning

confidence: 93%

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Hodgkin lymphoma variant of Richter transformation: morphology, Epstein-Barr virus status, clonality, and survival analysis—with comparison to Hodgkin-like lesion

et al. 2016

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Hodgkin/Reed-Sternberg (HRS) cells in the setting of chronic lymphocytic leukemia (CLL) exist in two forms: type I with isolated HRS cells in a CLL background (Hodgkin-like lesion), and type II with typical classic Hodgkin lymphoma (CHL), a variant of Richter transformation (CHL-RT). The clinical significance of the two morphological patterns is unclear, and their biological features have not been compared. We retrospectively reviewed 77 cases: 26 of type I and 51 of type II CHL-RT; 3 cases progressed from type I to type II. We examined clinical features, EBV status, and clonal relatedness after microdissection. Median age for type I was 62 years vs. 73 years for type II (p=0.01). 27% (type I) vs. 73% (type II) had a history of CLL. HRS cells were positive for EBV in 71% (55/77), similar in type I and II. Clonality analysis was performed in 33 cases (type I and type II combined): HRS cells were clonally related to the underlying CLL in 14 and unrelated in 19. ZAP-70 expression of the CLL cells, but not EBV status or morphological pattern was correlated with clonal relatedness: all 14 clonally related cases were ZAP-70-negative while 74% (14/19) of clonally unrelated cases were ZAP-70-positive. Overall median survival (types I and II) after diagnosis was 44 months. Advanced age was an adverse risk factor for survival, but not histological pattern, type I vs type II. HRS-like cells in a background of CLL carries a similar clinical risk to that of CHL-RT, and may progress to CHL in some cases.

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Section: Introductionmentioning

confidence: 93%

“…Most cases are diffuse large B-cell lymphoma (DLBCL) (1, 3, 4). The classical Hodgkin lymphoma variant of Richter transformation (CHL-RT) is rare (0.4%-0.7%)(1-3), (5-7)…”

Section: Introductionmentioning

confidence: 99%

Hodgkin lymphoma variant of Richter transformation: morphology, Epstein-Barr virus status, clonality, and survival analysis—with comparison to Hodgkin-like lesion

et al. 2016

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“…Chemo- and radiotherapy are the usual treatments of HL, and most of patients survive many years under control [16], [17]. However, the huge growth of the spleen, which may occur in some patients, leads to abdominal discomfort and therapeutic resistance.…”

Section: Discussionmentioning

confidence: 99%

“…Splenectomy has a very limited role in the treatment of Hodgkin’s lymphoma (HL) and is recommended only to control HL activity that does not respond to chemo- and radiotherapy [16], [17]. Since the purpose of a splenectomy is not to make the patient asplenic, a partial splenectomy may achieve the objectives without the adverse side effects of the total removal of the spleen [18], [19], [20].…”

Section: Introductionmentioning

confidence: 99%

Subtotal splenectomy preserving the inferior splenic pole for the treatment of Hodgkin’s lymphoma

Petroianu

2017

International Journal of Surgery Case Reports

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HighlightsFirst published case of subtotal splenectomy preserving the inferior splenic pole without the maintenance of the splenic vascular pedicle.A very large spleen Hodgkin’s disease was successfully treated using a partial splenectomy.A successful surgical treatment on a Hodgkin’s lymphoma refractory to chemo and radiotherapy.The patient is still alive after more than 11 years from the subtotal splenectomy.Subtotal splenectomy is efficacious to preserve the splenic functions and to prevent adverse effects of a large spleen on the treatment of Hodgkin’s lymphoma.Subtotal splenectomy is sufficient to reduce the inconvenience of a huge spleen on patient symptoms and disorders of the hematological and immunological system.

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“…Hodgkin's lymphoma (HL) variant of Richter transformation is relatively rare (0.4%) (1), and only approximately 100 cases have been reported in the literature (2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

MDR-1 gene polymorphisms G2677T and C3435T in a case of Hodgkin’s variant of Richter’s syndrome

et al. 2011

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Abstract. Richter's syndrome is defined as the transformation of low-grade lymphoma to a more aggressive high-grade malignant form, usually diffuse large B-cell lymphoma. Hodgkin's lymphoma variant of Richter transformation is relatively rare, and only approximately 100 cases have been reported in the literature. This study examined a case of a 53-year-old woman who developed Hodgkin's lymphoma almost 5 years after the diagnosis of chronic lymphocytic leukemia (CLL). The major points of interest regarding CLL with Hodgkin's transformation were also considered, such as the potential role of MDR-1 gene polymorphisms. The patient was evaluated for two MDR-1 gene polymorphisms, G2677T polymorphism in exon 21 and silent C3435T polymorphism in exon 26, to ascertain whether polymorphisms affect the risk of Hodgkin's lymphoma variant of Richter transformation and whether genomic polymorphisms provide prognostic information on the clinical progression of the disease. According to the data obtained, the analysis of polymorphisms in the MDR1 gene exons 21 and 26 revealed that the T2677T and T3435T alleles are not a predisposing factor to Richter transformation, while the presence of the wild-type genotype may be associated with a more favorable response to therapy.

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Partially successful treatment of a patient with chronic lymphocytic leukemia and Hodgkin's disease: Case report and literature review

Abstract: Chronic lymphocytic leukemia (CLL) is rarely associated with Hodgkin's disease (HD).We report a case of nodular sclerosis HD in a patient previously diagnosed with CLL.

Cited by 24 publications

References 28 publications

Hodgkin lymphoma variant of Richter transformation: morphology, Epstein-Barr virus status, clonality, and survival analysis—with comparison to Hodgkin-like lesion

Hodgkin lymphoma variant of Richter transformation: morphology, Epstein-Barr virus status, clonality, and survival analysis—with comparison to Hodgkin-like lesion

Subtotal splenectomy preserving the inferior splenic pole for the treatment of Hodgkin’s lymphoma

MDR-1 gene polymorphisms G2677T and C3435T in a case of Hodgkin’s variant of Richter’s syndrome

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