A new nationwide study showed that the 5-year cumulative incidence of Richter transformation (RT) among patients with chronic lymphocytic leukemia (CLL) was 2.8%. Of those patients whose disease transformed, about half (49%) were treatment-naive prior to transformation.
The researchers identified 3 factors associated with increased risk for transformation: advanced Binet stage (P<.001), unmutated immunoglobulin heavy chain variable IGHV genes (P <.001), and del(17p) (P <.001).
Among those patients diagnosed with RT after initiating treatment for CLL, 53% developed it after first-line treatment, 24% after second-line treatment, and 22% after 3 or more lines.
The median overall survival among patients with CLL and RT was 3.1 years. Those patients who were previously treated for CLL had a worse overall survival than those who were treatment naive (2.8 years vs 6.1 years; P =.03). Whether this finding could be explained by a higher proportion of clonally unrelated RT among treatment-naïve patients, remain to be addressed.
A bit more information here: cancertherapyadvisor.com/ho...
and here: tandfonline.com/doi/full/10...