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 Sadeghi^2, , 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

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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