Abstract
Transformation is the evolution of an indolent lymphoma/leukemia to an aggressive lymphoma, typically harboring a very poor prognosis. This phenomenon is well described in humans, but underestimated in dogs although recognized as a possible evolution of indolent lymphomas/leukemias. In canine chronic leukemias, blast crisis (mainly in myeloid) and Richter syndrome (transformation into a high grade lymphoma) (mainly in B-cell lymphocytic leukemia) have been reported. Transformation is a possible event also in canine low grade lymphomas, although rare. The increased knowledge has also generated new questions and posed challenges that need to be addressed to improve outcome, including the recognition of the clinical characteristics at diagnosis associated with a higher risk of transformation in an attempt of anticipating the typical evolution.
Highlights
Transformation of an indolent low grade lymphoma into a more aggressive histotype is a well-known process in human hemato-oncology, generally linked to unfavorable prognosis and poor outcome
Most frequently (90% of cases), B-Chronic lymphocytic leukemia (CLL) transforms into diffuse large B-cell lymphoma (DLBCL), rarely (10%) into Hodgkin lymphoma [11]
Canine Follicular Lymphoma In contrast with humans, follicular lymphoma (FL) are rare in dogs, representing no more than 1% of cases [18]
Summary
Transformation of an indolent low grade lymphoma into a more aggressive histotype is a well-known process in human hemato-oncology, generally linked to unfavorable prognosis and poor outcome. Histological transformation of follicular lymphoma (FL) into more aggressive lymphoma subtypes is a pivotal event in the natural history of patients, representing one of the major challenges in the management of patients with FL. Transformation has been reported in other subtypes of low grade lymphomas, either B-cell (marginal zone lymphoma – MZL, mantle cell lymphoma – MCL, mucosa-associated lymphoid tissue lymphoma – MALT) or T-cell in origin (mycosis fungoides – MF), and generally implies the histological effacement of the nodal architecture and/or the increase in the proportion of large cells [1], together with the onset of clinical signs. The issue of transformation of lymphoma/leukemia into more aggressive forms is debated but anecdotic. Aim of the present article is to review the veterinary literature and to describe the authors’ experience
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