Revisiting Richter transformation in the era of novel CLL agents

[Jm954]

September 2021

A thorough review of where we are with the understanding and treatment of Richter's. Sadly, still not looking good but hopefully more understanding will lead to improved treatment and prognosis.

sciencedirect.com/science/a...

Jackie

[Newdawn Administrator]

Very helpful information Jackie though never easy for any CLL’er to read.

I keep reading about the exceptional success in treatment using Polivy (polatumazab vedotin) by Roche but haven’t heard much mention of it. I’m not sure if it’s being used beyond trials but outcomes sound very promising for this group of patients.

nice.org.uk/guidance/ta649

Newdawn

[turkey2 in reply to Newdawn]

I just now ran across your post; I've just finished my 4th Polivy treatment for relapsed DLBCL (RT) and rarely have been able to find much information about it. My oncologist told me it wouldn't be as hard on my as the previous R-CHOP, but I'm not so sure. Last week's PET scan showed good results, so am cautiously optimistic. Thanks for the link -

[Newdawn Administrator in reply to turkey2]

Sending you best wishes for a really good outcome turkey.

Newdawn

[mrsjsmith]

Thank you Jackie,

And additional comments by Newdawn, and hopefully we will never need to investigate any of those treatments.

Colette 🤞

[johnliston]

Didn't see anything about IGHV4-39usage which I had previously read had a high risk (HR 4.03 over wild type) of richters transformation. Has something changed?

john

[Jm954 Administrator in reply to johnliston]

Not sure anything has changed. They don't seem to have looked at IGHV in any detail apart from mutated/non mutated. The difficulty is always (and thankfully) small numbers and then drawing conclusions from apparent correlations which may or may not be correct.Jackie

[Smakwater]

Lots to digest here. Some of what I am getting is that not much has changed in treating Richters, and that the unmutated group is still the risk focus.

No doubt that Covid needs have taken wind from the richters research sails the past few seasons.

JM

[virdieblue]

No good news there! Virginia

[beanlake14]

Lost a dear friend to RT. Scary to read how many risk factors I have, but it’s good to be prepared with this information. Wendy tried RCHOP, plus several other drugs before CAR T, but was just too ill.

[Jm954 Administrator in reply to beanlake14]

I'm sorry to hear that.

It's sad that the most curative option isn't offered until people are exhausted and compromised by so many sessions of heavy chemotherapy. It's the same in the UK, NICE has recommended CAR-T but only after 2 previous regimes have failed.

Jackie

[johnliston in reply to Jm954]

Jackie, Is CAR T considered a curative treatment or just a bridge to stem cell transplant?

john

[Jm954 Administrator in reply to johnliston]

Intended to be curative and superior to transplant, if it works.

[beanlake14 in reply to Jm954]

It was that way with Wendy. So many treatments. She was tired

[Jm954 Administrator in reply to beanlake14]

😓😓😓