Hello everyone
Yesterday I had the pleasure of attending a conference given by the pathologist PR Elias Campo at the Oncopole hospital in Toulouse.
The topic was to talk about LLC and above all the main topic was the Richter Transformation.
It was the first time that this transformation was discussed in a conference as a main topic. The pathologist Elías Campo was able to carry out a study thanks to some biopsies sent to him by members of this group who were not satisfied with the diagnosis of RT and requested a second opinion.
The result of the study is that many patients are being treated by RT or Lymphoma as we want to call it when in reality it is not. There are different types of RT, such as very aggressive ones that spread quickly and are sometimes confused with LLC. Here is the problem, because it is diagnosed too late.
There are others that are slower growing and take longer to diagnose.
Then there are the Rictherts or Pseudo Ricthers which I call Richter's ghosts.
They are diagnosed after withdrawing Ibrutinib for a few days for an intervention or biopsy. For most people who have had a biopsy done and had Ibrutinib temporarily withdrawn, I warned them to be careful because it could be diagnosed as RT, as it has been.
One of the members of this group would have already been scheduled to receive the R-CHOP and a transplant without having tumor growth and only because the biopsy was positive in RT. I told him to send the biopsies to the pathologist Elias Campo. Result? It was not RT, but Ibrutinib temporarily transformed the cell. This person saved chemotherapy and a cell transplant that would have been useless.
Dr. Elías Campo warned that when they see a transformation they do not have to settle for what they see in the biopsy and ask for a second opinion, since the results can turn 180 degrees. More specific studies must be done to confirm if it really is a RT or not. With which the doctor has to have a little intuition and evaluate the patient's condition along with other factors before applying a treatment.
He also commented on the importance of sharing files between hospitals with RT patients because they are very few and it is impossible to study them, which makes it impossible to know why it occurs and the mutation is unknown.
As we have the Ricther Transformation group, and we are many cases, he told me that it would be advisable to take the maximum number of biopsies to be able to study them and thus know how to attack the true RT.
The pathologist Elias Campo is willing to study his cases and share his studies with other hospitals that want to participate in this project.
He gathers all the files for a professional RT expert to study and weed out the real RTs from the ones that aren't.
I share some images that I was able to obtain with my cell phone, of studies of two cases of RT that were not really RT and one of them was my case.
Dr. Elias Campo is convinced that by studying many cases at the same time they will be able to carry out a more complete study and attack the true RT with the appropriate treatments.
In this group from now on I will put where to send the biopsies if you want a second opinion and study your case together with the other cases. Anyone who has doubts will be able to have a more exhaustive examination of his case and assure him of a good deal if he needs it and save an aggressive treatment if he does not need it.
We are moving forward and we have to make sure that the Richter Transform is studied and stops being a bad forecast.
A phrase of recommendation from Dr. Elias Campo to doctors. - You have to rely on logic in these cases and know how to differentiate a RT from what is not and if it is, diagnose it as quickly as possible - .
My best wishes
Richters update
Leukaemia Care Updated Patient Information - Richter's Syndrome in Chronic Lymphocytic Leukaemia 
