PB1882: RICHTER TRANSFORMATION FEATURES, SURVIVAL AND TREATMENT OUTCOME IN HEMATOLOGY CLINIC OF CRAIOVA, ROMANIA

Abstract

Background: Richter transformation is a rare but potential lethal complication in patients diagnosed with chronic limphocytic leukemia. The most common histological transformation is of Hodgkin lymphoma or Diffuse Large B-cell lymphoma type. Aims: The aim is to assess the clinicopathological characteristics survival and treatment in Richter transformation patients diagnosed and treated in Hematology Clinic of Craiova in the last 10 years. Methods: Between January 2012 and January 2022, 453 patients with chronic lymphocytic leukemia (CLL) were diagnosed and treated in our clinic, 121 female and 332 male. Results: Median age of the patients was 68 years and the male:female ratio was 2,74. The majority were diagnosed in A stage (52%), 27% in B stage and 21% in C stage. 29% of patients required treatment initiation upon diagnosis. Richter transformation occurs in 1,76 % cases (8/453) of all CLL. The transformation occurred as follows: 5 diffuse large B-cell lymphoma (DLBCL)-type pacients and 3 Hodgkin lymphoma-type pacients. In all cases the mutational status was unmutated, CD38 was positive in 6 patients and 3 patients were positive for TP53 mutation. The time until transformation lasted between 6 and 42 months, measured from treatment initiation. In 6 patients, transformation involved peripheral lymphadenopathy and in 2 patients, intraabdominal lymphadenopathy. The treatment received was ABVD regimen in Hodgkin transformation and R CHOP in DLBCL-type. On average, survival was 16 months in Hodgkin transformation and 7,8 months in DLBCL transformation. Summary/Conclusion: The Richter transformation is a rare complication of CLL, an indolent lymphoproliferative disorder. Only 8 patients were diagnosed with Richter transformation in our clinic in the last 10 years. Chemotherapy response was poor and survival was short.