Hodgkin transformation of chronic lymphocytic leukemia
Open Access
- 1 September 2006
- Vol. 107 (6), 1294-1302
- https://doi.org/10.1002/cncr.22121
Abstract
BACKGROUND Hodgkin transformation is a rare complication of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). In this study, the authors assessed the incidence, presenting characteristics, and outcomes of patients with CLL/SLL who developed Hodgkin lymphoma (HL). METHODS An electronic database search of patients with CLL/SLL who presented at The University of Texas M. D. Anderson Cancer Center Department of Leukemia between 1975 and 2005 was performed. RESULTS Among 4121 patients with CLL/SLL, 18 patients (0.4%) developed HL. Presenting features included B-symptoms (67%), lymph node enlargement (79%), splenomegaly (43%), hepatomegaly (29%), hypercalcemia (6%), infection (6%), and mental status changes (6%). The median age was 72 years (range, 49–81 years), and there was a male preponderance (78%). The median time from CLL to HL diagnosis was 4.6 years (range, 0–12.9 years). Fourteen patients (78%) had been previously treated for CLL/SLL. Ten patients (56%) had received >1 prior therapy. The median β2-microglobulin level was 4.5 mg/L, and the median lactate dehydrogenase level was 610 IU/L. Epstein–Barr virus (EBV) was positive by in situ hybridization for EBV-encoded RNA in 3 of 4 tested patients. Fourteen patients (78%) received chemotherapy. The overall response rate was 44% (complete response rate, 19%). The median overall survival duration was 0.8 years (range, 0.03 years–6.7+ years). The median failure-free survival (FFS) duration was 0.4 years. CONCLUSIONS The rates of response, survival, and FFS in patients with Hodgkin transformation of CLL/SLL were inferior to those reported in patients with de novo HL and were similar to those in patients with Richter syndrome. Cancer 2006. © 2006 American Cancer Society.Keywords
This publication has 27 references indexed in Scilit:
- Clinical Outcomes and Prognostic Factors in Patients With Richter's Syndrome Treated With Chemotherapy or Chemoimmunotherapy With or Without Stem-Cell TransplantationJournal of Clinical Oncology, 2006
- Introduction of Combined CHOP Plus Rituximab Therapy Dramatically Improved Outcome of Diffuse Large B-Cell Lymphoma in British ColumbiaJournal of Clinical Oncology, 2005
- Hodgkin's Type of Richter's Syndrome in Familial Chronic Lymphocytic Leukemia Treated with Cladribine and CyclophosphamideLeukemia & Lymphoma, 2003
- Hodgkin’s disease type Richter’s syndrome in chronic lymphocytic leukemiaLeukemia, 1999
- A Prognostic Score for Advanced Hodgkin's DiseaseThe New England Journal of Medicine, 1998
- Hodgkin's disease developing after spontaneous remission of chronic lymphocytic leukemiaAnnals of Hematology, 1995
- Hodgkin's disease in CLLAmerican Journal of Hematology, 1995
- Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin's disease: results of a BNLI randomised trialThe Lancet, 1993
- Chronic Lymphocytic Leukemia with Coexistent Hodgkinʼs DiseaseThe American Journal of Surgical Pathology, 1991
- Morphological and immunohistochemical investigation of non‐Hodgkin's lymphoma combined with Hodgkin's diseaseHistopathology, 1989