Hodgkin's variant of Richter transformation in chronic lymphocytic leukemia; a retrospective study from the Israeli CLL study group

Anticancer Res. 2014 Feb;34(2):785-90.

Abstract

Background: Richter syndrome (RS) is the development of an aggressive lymphoid malignancy, in chronic lymphocytic leukemia (CLL). Most are diffuse large B-cell lymphomas (DLBCL), however in 10-15% of RS, there is transformation to Hodgkin lymphoma, termed "Hodgkin variant" (HV). In the present retrospective study we summarize the Israeli experience with HV-RS, and analyze demographic data, relevant laboratory and clinical parameters, and outcome.

Patients and methods: We collected and analyzed data from 119 patients with RS from 12 Centers in Israel during 1996-2010 and identified 16 cases with "Hodgkin's variant".

Results: The median age was 58 years, and 67% were males. The median time from CLL diagnosis to development of HV was 5.9 (range=0.8-11.9) years and the median survival was 39.5 months, compared to 9 months for the cases with RS-DLBCL.

Conclusion: Hodgkin variant appears to differ from DLBCL-RS and is clinically less aggressive. However, compared to de novo Hodgkin's lymphoma, HV-RS has a worse prognosis.

Keywords: CLL; Hodgkin's Lymphoma; Hodgkin's variant; Richter syndrome; Richter transformation; chronic lymphocytic leukemia.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Cell Transformation, Neoplastic / pathology*
  • Female
  • Hodgkin Disease / pathology*
  • Humans
  • Israel
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology*
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Treatment Outcome