Richter综合征1例并文献复习
|
摘要
慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)发生Richter转化的机制尚未完全明确,治疗上通常参照侵袭性非霍奇金淋巴瘤或急性淋巴细胞白血病的联合化疗方案。CLL发生Richter转化后治疗效果差,但近年发现其异质性也较大,临床医师对具有危险因素的患者应提高警惕,争取早诊断、早干预。为提高对CLL发生Richter转化的认识,现报告1例发生Richter转化的CLL患者,并对其发生率、危险因素及可能的机制进行文献复习。
The mechanism of chronic lymphocytic leukemia(CLL) with Richter transformation is not fully clear, the combined chemotherapy regimens of aggressive non-Hodgkin's lymphoma or acute lymphoblastic leukemia are usually referenced. The treatment effect of CLL after Richter transformation is poor, but the heterogeneity is obvious. The clinical physicians should pay attention to the patients with risk factors and strive for the early diagnosis and early intervention. To deepen the understandings of CLL with Richter transformation, we report one case of CLL with Richter transformation, and review the literature of its incidence, risk factors, and possible mechanism.
The mechanism of chronic lymphocytic leukemia(CLL) with Richter transformation is not fully clear, the combined chemotherapy regimens of aggressive non-Hodgkin's lymphoma or acute lymphoblastic leukemia are usually referenced. The treatment effect of CLL after Richter transformation is poor, but the heterogeneity is obvious. The clinical physicians should pay attention to the patients with risk factors and strive for the early diagnosis and early intervention. To deepen the understandings of CLL with Richter transformation, we report one case of CLL with Richter transformation, and review the literature of its incidence, risk factors, and possible mechanism.
引文
1.Richter MN.Generalized reticular cell sarcoma of lymph nodes associated with lymphatic leukemia[J].Am J Pathol,1928,4(4):285-292.
2 .Rssi D,Cerri M,Capello D,et al.Biological and clinical risk factors of chronic ly mphoc y tic leuk aemia transformation to R ichter syndrome[J].Br J Haematol,2008,142(2):202-215.
3 .Fangazio M,De Paoli L,Rossi D,et al.Predictive markers and driving factors behind Richter syndrome development[J].Ex pert Rev Anticancer Ther,2011,11(3):433-442.
4 .Rasi S,Spina V,Bruscaggin A,et al.A variant of the LRP4 gene affects the risk of chronic lymphocytic leukaemia transformation to Richter syndrome[J].Br J Haematol,2011,152(3):284-294.
5 .Aydin S,Rossi D,Bergui L,et al.CD38 gene polymorphism and chronic lymphocytic leukemia:a role in transformation to richter syndrome[J].Blood,2008,111(12):5646-5653.
6 .Yee KW,O'Brien SM,Giles FJ.Richter’s syndrome:biology and therapy[J].Cancer J,2005,11(3):161-174.
7 .Maddocks-Christianson K,Slager SL,Zent CS,et al.Risk factors for development of a second lymphoid malignancy in patients with chronic lymphocytic leukaemia[J].Br J Haematol,2007,139(3):398-404.
8 .Catovsky D,Richards S,Matutes E,et al.Assessment of fludarabine plus cyclophosphamide for patients with chronic lymphocytic leukemia(the LRF CLL4 Trial):a randomized controlled trial[J].Lancet,2007,370(9583):230-239.
9 .El-Asmar J,Kharfan-Dabaja MA.Hematopoietic cell transplantation for Richter syndrome[J].Biol Blood Marrow Transplant,2016,22(11):1938-1944.
10 .Eyre TA,Clifford R,Boyle L,et al.Single arm NCRI phase II study of CHOP in combination w ith Ofatumumab in induction and maintenance for patients with newly diagnosed Richter’s syndrome[J].BMC Cancer,2015,15:52.
11 .Tsimberidou AM,O’Brien S,Khouri I,et al.Clinical outcomes and prognostic factors in patients with Richter's syndrome treated with chemotherapy or chemoimmunotherapy with or without stem-cell transplantation[J].J Clin Oncol,2006,24(15):2343-2351.
2 .Rssi D,Cerri M,Capello D,et al.Biological and clinical risk factors of chronic ly mphoc y tic leuk aemia transformation to R ichter syndrome[J].Br J Haematol,2008,142(2):202-215.
3 .Fangazio M,De Paoli L,Rossi D,et al.Predictive markers and driving factors behind Richter syndrome development[J].Ex pert Rev Anticancer Ther,2011,11(3):433-442.
4 .Rasi S,Spina V,Bruscaggin A,et al.A variant of the LRP4 gene affects the risk of chronic lymphocytic leukaemia transformation to Richter syndrome[J].Br J Haematol,2011,152(3):284-294.
5 .Aydin S,Rossi D,Bergui L,et al.CD38 gene polymorphism and chronic lymphocytic leukemia:a role in transformation to richter syndrome[J].Blood,2008,111(12):5646-5653.
6 .Yee KW,O'Brien SM,Giles FJ.Richter’s syndrome:biology and therapy[J].Cancer J,2005,11(3):161-174.
7 .Maddocks-Christianson K,Slager SL,Zent CS,et al.Risk factors for development of a second lymphoid malignancy in patients with chronic lymphocytic leukaemia[J].Br J Haematol,2007,139(3):398-404.
8 .Catovsky D,Richards S,Matutes E,et al.Assessment of fludarabine plus cyclophosphamide for patients with chronic lymphocytic leukemia(the LRF CLL4 Trial):a randomized controlled trial[J].Lancet,2007,370(9583):230-239.
9 .El-Asmar J,Kharfan-Dabaja MA.Hematopoietic cell transplantation for Richter syndrome[J].Biol Blood Marrow Transplant,2016,22(11):1938-1944.
10 .Eyre TA,Clifford R,Boyle L,et al.Single arm NCRI phase II study of CHOP in combination w ith Ofatumumab in induction and maintenance for patients with newly diagnosed Richter’s syndrome[J].BMC Cancer,2015,15:52.
11 .Tsimberidou AM,O’Brien S,Khouri I,et al.Clinical outcomes and prognostic factors in patients with Richter's syndrome treated with chemotherapy or chemoimmunotherapy with or without stem-cell transplantation[J].J Clin Oncol,2006,24(15):2343-2351.