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Prolonged remission in a case of Richter's transformation of B-cell chronic lymphocytic leukaemia following adoptive immunotherapy

Bone Marrow Transplantation volume 38, pages 461–462 (2006)Cite this article

There is increasing evidence of a potent graft-versus-leukaemia effect in B-CLL. In a recent study of nine patients with poor prognosis B-CLL and unmutated IgVh genes, seven were still free of MRD at 2 years, although disease progression was observed in a case with 17p deletion.4 Response of Richter's transformation to allo-HSCT has been reported previously.5 However, it is difficult to distinguish the contribution of conditioning therapy and the allogeneic effect in this study. In the present case, disease progression in the early post transplant period unequivocally demonstrated that the prolonged remission was induced by adoptive immunotherapy. There are theoretical grounds to suggest that Rituximab therapy may have been synergistic with the DLI in initial remission induction. However, the peripheral lymphocytosis remained until the onset of GVHD, and fell consistently before the introduction of steroid therapy. In summary, effective remission was achieved in this patient at the onset of GVHD induction, despite progressive disease early post transplant.

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References

  1. Shanafelt TD, Geyer SM, Kay NE . Prognosis at diagnosis: integrating molecular biologic insights into clinical practice for patients with CLL. Blood 2004; 103: 1202–1210.

    Article  CAS  Google Scholar 

  2. Tsimberidou AM, Keating MJ . Richter syndrome: biology, incidence, and therapeutic strategies. Cancer 2005; 103: 216–228.

    Article  CAS  Google Scholar 

  3. Rawstron AC, Kennedy B, Evans PA, Davies FE, Richards SJ, Haynes AP et al. Quantitation of minimal disease levels in chronic lymphocytic leukemia using a sensitive flow cytometric assay improves the prediction of outcome and can be used to optimize therapy. Blood 2001; 98: 29–35.

    Article  CAS  Google Scholar 

  4. Ritgen M, Stilgenbauer S, von Neuhoff N, Humpe A, Bruggemann M, Pott C et al. Graft-versus-leukemia activity may overcome therapeutic resistance of chronic lymphocytic leukemia with unmutated immunoglobulin variable heavy-chain gene status: implications of minimal residual disease measurement with quantitative PCR. Blood 2004; 104: 2600–2602.

    Article  CAS  Google Scholar 

  5. Rodriguez J, Keating MJ, O'Brien S, Champlin RE, Khouri IF . Allogeneic haematopoietic transplantation for Richter's syndrome. Br J Haematol 2000; 110: 897–899.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Haematological Medicine, Kings College Hospital, Denmark Hill, London, UK

    D Milojković, A Pagliuca, G J Mufti & S Devereux

  2. Department of Haematology, Medway Maritime Hospital, Gillingham, Kent, UK

    M Aldouri

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  1. D Milojković
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  2. M Aldouri
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  3. A Pagliuca
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  4. G J Mufti
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  5. S Devereux
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Correspondence to D Milojković.

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Milojković, D., Aldouri, M., Pagliuca, A. et al. Prolonged remission in a case of Richter's transformation of B-cell chronic lymphocytic leukaemia following adoptive immunotherapy. Bone Marrow Transplant 38, 461–462 (2006). https://doi.org/10.1038/sj.bmt.1705469

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