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Outcomes of Richter’s transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL): an analysis of the SEER database

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Abstract

Richter’s transformation (RT) is a rare complication arising in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and is associated with an overall dismal outcome. The rarity of this entity poses many challenges in understanding its biology and outcomes seen and the optimal treatment approach. We utilized the SEER (Surveillance, Epidemiology and End Results) database to identify patients diagnosed with CLL/SLL between 2000 and 2016 and subsequently had a diagnosis of diffuse large B-cell lymphoma (DLBCL) or Hodgkin lymphoma (HL), thus capturing those who experienced an RT event. We compared the outcomes of those patients to those of patients in the database diagnosed with DLBCL without a preceding CLL/SLL diagnosis. We identified 530 patients who developed RT out of 74,116 patients diagnosed with CLL/SLL in the specified period. The median age at RT diagnosis was 66 years, and the median time from CLL/SLL diagnosis to RT development was roughly 4 years. Patients with RT had a dismal outcome with median overall survival of 10 months. We identified advanced Ann Arbor stage (III/IV) and prior treatment for CLL as predictors of worse outcome in patients with RT. Our study represents the largest dataset of patients with CLL/SLL and RT and adds to the existing literature indicating the poor outcomes for those patients.

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Authors and Affiliations

  1. Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE, 68198, USA

    Radowan Elnair, Avyakta Kallam & Robert G. Bociek

  2. Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA

    Moataz Ellithi

  3. College of Public Health, Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA

    Valerie Shostrom

Authors
  1. Radowan Elnair
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  2. Moataz Ellithi
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  3. Avyakta Kallam
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  4. Valerie Shostrom
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  5. Robert G. Bociek
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Correspondence to Radowan Elnair.

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This article does not contain any studies with human participants performed by any of the authors.

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This study utilized a widely available database. Individual patient consent was thus not obtained for the purpose of this study. All data were collected and used following the SEER policies and procedures.

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The authors declare no competing interests.

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Elnair, R., Ellithi, M., Kallam, A. et al. Outcomes of Richter’s transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL): an analysis of the SEER database. Ann Hematol 100, 2513–2519 (2021). https://doi.org/10.1007/s00277-021-04603-y

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  • DOI: https://doi.org/10.1007/s00277-021-04603-y

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