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Dr Sharman explains how treatment options for the two main subtypes of the aggressive Diffuse Large B Cell Lymphoma are changing

Dr Sharman explains how treatment options for the two main subtypes of the aggressive Diffuse Large B Cell Lymphoma are changing

Diffuse Large B Cell Lymphomas are aggressive lymphomas that those of us with CLL face a chance of developing in what is termed Richter's Transformation. Given the risk increases the longer we live with CLL and at between 5 and 15% is not insignificant, if you notice any bumps quickly growing, get them checked out promptly.

In this very technical blog, Dr Sharman explains how the two main DLBCL subtypes are identified and how this influences treatment.

He also provides some interesting information on the wide difference in treatment response observed with lenalidomide and ibrutinib drugs when treating the two main DBLC subtypes and concludes "I think we are getting really close to making some important steps forward in the management of DLBCL-NOS and it will be driven by molecular information that leads to targeted therapies that are specific to the patient."


These cockatoos were enjoying munching on some pine cones when I interrupted their feeding. I subsequently 'captured' them keeping a watchful eye on me after they relocated to a safe perch in a nearby eucalyptus (gum) tree.

5 Replies

Interesting. These things always get more complicated, the more you look at them, but I like the way Dr Sharman talks - very human and nice clear language.


Richter's is DLBCL, but it may be different than ABC or GBC... there are two Richter's DLBCL as well... complexity we are just beginning to understand...

Bumps or lumps get to a doctor as Neil mentioned... time matters... days count... the sooner you begin treatment, the better the outcome. Further, Richter's can happen at ANY TIME... although perhaps time from diagnosis may be a factor...

As a Richter's patient, I would like to make a point...

Only read the most recent research, our understand of Richter's is very incomplete and changes frequently... much of what was 3-5 years ago may no longer apply...

Imbruvica (ibrutinib) does not PREVENT a Richter's transformation, nor does it treat it as a mono therapy...



A friend of mine was just diagnosed with richters transformation, and you Chris where on my mind with your positive attitude and "succes" :-)

Neil, your photos always make me wanna run to the nearest airport asap for a trip away from the cold (today -5 degr C with a chillfactor of minus 15 degr C)


Thank you Damms!... being positive is very important. It makes RCHOP work better ;-)


Sorry to hear about your friend Damms; hopefully our improving understanding of Richter's Transformation will help.

I've been appreciating Chris's cool, damp photos, so it works the other way for me too. Yesterday it got to about 30C, 12C overnight. It is already 29C today at 8AM sun time, so another hot day today with a predicted maximum of 32. When I went for a lunch time walk yesterday, the birds were singing away, so they didn't seem to mind the warm weather despite their feather insulation. There was the occasional cooling sea breeze too :) . We're expecting a cool week - down to 22C, then warming up next weekend. I don't know how people arriving from your winter manage the transition to our 30 - 40C summers in less than a day's travel. Perhaps trying to stay awake when they want to be asleep and vice versa numbs the climate shock!


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