Factors predicting survival in chronic lymphocytic leukemia patients developing Richter syndrome transformation into Hodgkin lymphoma

Luca Laurenti, Idanna Innocenti, Robin Foa, Francesca Romana Mauro, Piero Galieni, Alessandra Tedeschi, Giovanni Del Poeta, Gianluigi Reda, Marina Motta, Alessandro Gozzetti, Roberta Murru, Maria Denise Caputo, Melissa Campanelli, Anna Maria Frustaci, Sara Raponi, Anna Guarini, Fortunato Morabito, Robin Foà, Massimo Gentile

Risultato della ricerca: Contributo in rivistaArticolo in rivista

11 Citazioni (Scopus)

Abstract

We hereby report the clinical and biologic features of 33 of 4680 (0.7%) patients with chronic lymphocytic leukemia (CLL), managed at 10 Italian centers, who developed Hodgkin lymphoma (HL), a rare variant of Richter syndrome. The median age at CLL and at HL diagnosis were 61 years (range 41-80) and 70 years (range 46-82), respectively, with a median interval from CLL to the diagnosis of HL of 90 months (range 0-258). In 3 cases, CLL and HL were diagnosed simultaneously. Hl was characterized by advanced stage in 79% of cases, International Prognostic Score (IPS) ≥4 in 50%, extranodal involvement in 39%, B symptoms in 70%. Prior treatment for CLL had been received by 82% of patients and included fludarabine in 67%. Coexistence of CLL and HL was detected in the same bioptic tissue in 87% of cases. The most common administered treatment was the ABVD regimen given to 22 patients (66.6%). The complete response (CR) rate after ABVD was 68%, and was influenced by the IPS (P =.03) and interval from the last CLL treatment (P =.057). Survival from HL was also influenced by the IPS (P =.006) and time from the last CLL treatment (P =.047). The achievement of CR with ABVD was the only significant and independent factor predicting survival (P =.037). Taken together, our results show that the IPS and the interval from the prior CLL treatment influence the likelihood of achieving CR after ABVD, which is the most important factor predicting survival of patients with CLL developing HL.
Lingua originaleEnglish
pagine (da-a)529-535
Numero di pagine7
RivistaAmerican Journal of Hematology
Volume92
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols
  • Bleomycin
  • Combined Modality Therapy
  • Dacarbazine
  • Doxorubicin
  • Female
  • Hematology
  • Hodgkin Disease
  • Humans
  • Immunoglobulin Heavy Chains
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Male
  • Middle Aged
  • Mutation
  • Neoplasms, Second Primary
  • Prognosis
  • Remission Induction
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Vinblastine

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