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

Autor: Roberta Murru, Alessandra Tedeschi, Alessandro Gozzetti, Anna Guarini, Robin Foà, Fortunato Morabito, Giovanni Del Poeta, Anna Maria Frustaci, Melissa Campanelli, Sara Raponi, Luca Laurenti, Piero Galieni, Gianluigi Reda, Idanna Innocenti, Maria D Caputo, Francesca Romana Mauro, Marina Motta, Massimo Gentile
Rok vydání: 2017
Předmět:
Oncology
Male
Chronic lymphocytic leukemia
0302 clinical medicine
immune system diseases
Risk Factors
hemic and lymphatic diseases
Neoplasms
Antineoplastic Combined Chemotherapy Protocols
80 and over
Adult
Aged
Aged
80 and over
Bleomycin
Combined Modality Therapy
Dacarbazine
Doxorubicin
Female
Hodgkin Disease
Humans
Immunoglobulin Heavy Chains
Leukemia
Lymphocytic
Chronic
B-Cell
Middle Aged
Mutation
Neoplasms
Second Primary
Prognosis
Remission Induction
Retrospective Studies
Treatment Outcome
Vinblastine
Hematology
Chronic
Leukemia
Lymphocytic
Fludarabine
Second Primary
B symptoms
030220 oncology & carcinogenesis
medicine.symptom
medicine.drug
medicine.medical_specialty
ABVD Regimen
03 medical and health sciences
Internal medicine
medicine
business.industry
B-Cell
medicine.disease
Settore MED/15
Settore MED/15 - MALATTIE DEL SANGUE
ABVD
Immunology
business
030215 immunology
Zdroj: American journal of hematology. 92(6)
ISSN: 1096-8652
Popis: 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.
Databáze: OpenAIRE
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