American Journal of Cancer Prevention
ISSN (Print): 2328-7314 ISSN (Online): 2328-7322 Website: http://www.sciepub.com/journal/ajcp Editor-in-chief: Nabil Abdel-Hamid
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American Journal of Cancer Prevention. 2015, 3(1), 1-3
DOI: 10.12691/ajcp-3-1-1
Open AccessCase Report

Type of Treatment Can Effect on Transformation of Chronic Lymphocytic Leukaemia to Diffuse Large B-cell Lymphoma: A Rare Case with Review of Literature

Mehrdad Payandeh1, Masoud Sadeghi2, , Edris Sadeghi3 and Seyed Hamid Madani4

1Department of Hematology and Oncology, Kermanshah University of Medical Sciences, Kermanshah, Iran

2Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

3Department of Nursing, Kermanshah University of Medical Sciences, Kermanshah, Iran

4Molecular Pathology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

Pub. Date: February 10, 2015

Cite this paper:
Mehrdad Payandeh, Masoud Sadeghi, Edris Sadeghi and Seyed Hamid Madani. Type of Treatment Can Effect on Transformation of Chronic Lymphocytic Leukaemia to Diffuse Large B-cell Lymphoma: A Rare Case with Review of Literature. American Journal of Cancer Prevention. 2015; 3(1):1-3. doi: 10.12691/ajcp-3-1-1

Abstract

Richter transformation is defined as a diffuse large cell lymphoma, occurring by transformation of chronic lymphocytic leukemia (CLL) and diffuse large B-cell lymphoma (DLBCL) is the most common type of richter syndrome. Herein, we describe report of a 51 year-old man in western Iran that referred to Hematology Clinic with complaint of three months of weight loss and sweating with generalized abdominal lymphadenopathy and the Bulky cervical lymph node. Pathology’s specimens for him demonstrated CLL in the patient (Rai system stage 4) and during seven years ago, he was treated with fludarabine and cyclophosphamide regiment for 6 courses. Cervical biopsy pathology reported a new diagnosis of diffuse large B-Cell lymphoma and also immunohistochemistry (IHC) analysis showed CD3, CD20, CD45 were positive and Bcl-2 was negative and so he was treated with new regiment of R-CHOP for 6 courses. One month after last course of chemotherapy, Cerebrospinal fluid cytology was positive with lymphomatous involvement, and also brain CT SCAN showed parenchymal involvement and therapy with high dose Methotrexate began for him. The result is that specialists should be careful that probably fludarabin therapy alone or combination it with other drug especially cyclophosphamide can effect on transformation CLL to DLBCL.

Keywords:
Cyclophosphamide Fludarabine Lymphoma Richter Syndrome

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References:

[1]  Olaniyi JA, Ibijola AA.Richter’s Syndrome: A Case Report. Med PrincPract. 2009.18(2):152-4.
 
[2]  Ishida F, Nakazawa H, Takezawa Y, Matsuda K, Asano N, Sano K, et al. Richter transformation in the brain from chronic lymphocytic leukemia.J ClinExpHematop. 2013.53(2):157-60.
 
[3]  Thornton PD, Bellas C, Santon A, Shah G, Pocock C, Wotherspoon AC, et al. Richter's transformation of chronic lymphocytic leukemia. The possible role of fludarabine and the Epstein-Barr virus in its pathogenesis. Leuk Res. 2005 Apr.29(4):389-95.
 
[4]  Español I, Büchler T, Ferrá C, Gallardo D, Reyes P, Sarrá J, et al. Richter's syndrome after allogeneic stem cell transplantation for chronic lymphocytic leukaemia successfully treated by withdrawal of immunosuppression, and donor lymphocyte infusion. Bone Marrow Transplant. 2003 Feb.31(3):215-8.
 
[5]  Ghofrani M, Tantiwongkosi B, Smith AS, Wasdahl DA. Richter transformation of chronic lymphocytic leukemia presenting as a dural-based non-hodgkinlymphomamass.AJNR Am J Neuroradiol. 2007 Feb.28(2):318-20.
 
[6]  Resende LS, Bacchi CE, Resende LA, Gabarra RC, Niéro-Melo L. ISOLATED RICHTER’S SYNDROME IN CENTRAL NERVOUS SYSTEM. ArqNeuropsiquiatr. 2005 Jun.63(2B):530-1.
 
[7]  Robak E, Góra-Tybor J, Kordek R, Wawrzyniak E, Bartkowiak J, Bednarek A, et al. Richter syndrome first manifesting as cutaneous B-cell lymphoma clonally distinct from primary B-cell chronic lymphocytic leukaemia.Br J Dermatol. 2005 Oct.153(4):833-7.
 
[8]  Yager NM, Ghate K, Swan RL, Farrokh A, Barba K, Beegle SH.A rare case of empyema. Answer: Transformation of CLL into diffuse large B-cell lymphoma, also known as Richter syndrome.Chest. 2013 Jul.144(1):350-3.
 
[9]  Salihoglu A, Ozbalak M, Keskin D, Tecimer T, Soysal T, Ferhanoglu B. An unusual presentation of a chronic lymphocytic leukemia patient with 17p deletion after reduced-intensity transplantation: Richter syndrome and concomitant graft-versus-host disease--case report.Transplant Proc. 2013 Sep.45(7):2845-8.
 
[10]  Yu L, Bandhlish A, Fullen DR, Su LD, Ma L. Cutaneous Richter syndrome: report of 3 cases from one institution.J Am AcadDermatol. 2012 Nov.67(5):e187-93.
 
[11]  Rasool J, Jeelani S, Jeelani S, Khan A, Lone MS. Chest Wall Swelling, A Rare Presentation of Richter's Transformation. Indian J Hematol Blood Transfus. 2010 Jun.26(2):70-2.
 
[12]  Kaźmierczak M, Kroll-Balcerzak R, Balcerzak A, Czechowska E, Gil L, Sawiński K, et al. Hodgkin lymphoma transformation of chronic lymphocytic leukemia: cases report and discussion. Med Oncol. 2014 Jan.31(1):800.
 
[13]  Solh M, Rai KR, Peterson BL, Kolitz JE, Appelbaum FR, Tallman MS, et al. The impact of initial fludarabine therapy on transformation to Richter syndrome or prolymphocytic leukemia in patients with chronic lymphocytic leukemia: analysis of an intergroup trial (CALGB 9011). Leuk Lymphoma. 2013 Feb.54(2):252-4.