Richter’s Transformation in Chronic Lymphocytic Leukemia

Telomere length is an independent predictor of survival, treatment requirement and Richter's syndrome transformation in chronic lymphocytic leukemia

“…RS is a severe event occurring in 10-15% of CLL patients. 15,50 Very few studies have investigated the features that at CLL diagnosis may TL ≤5000 bp 9/62 18.9% Figure 4 Telomere length (TL) as a predictor for transformation to Richter's syndrome (RS). The 5-year cumulative risk of transformation was 18.9% in patients with TLp5000 bp, as opposed to 6.4% for those with long telomeres.…”

Correlation between FDG/PET, histology, characteristics, and survival in 332 patients with chronic lymphoid leukemia

“…4 RS carries a dismal prognosis. In the historical experience of our institution, disease control can only be obtained in a fraction of patients and is of brief duration (complete response rates of 0% to 25%, failure-free survival of 1.3 to 5 months, and overall survival [OS] of 2.2 to 8.5 months).…”

How I treat CLL up front

“…85 The large cells of RS either arise through a transformation of the original CLL clone by the acquisition of new genetic abnormalities or less frequently represent a new secondary neoplasm. The clinical outcome of the disease is generally poor, with median survival of months from transformation, but prognosis is better when transformation occurs in previously untreated patients.…”