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里希特转化。

Richter's Transformation.

机构信息

Division of Hematology, Department of Internal Medicine, The Ohio State University, 11th Floor Lincoln Tower and 1140D Lincoln Tower, 1800 Cannon Drive, Columbus, OH, 43210, USA.

出版信息

Curr Oncol Rep. 2022 Aug;24(8):1081-1090. doi: 10.1007/s11912-022-01274-4. Epub 2022 Apr 6.

Abstract

PURPOSE OF REVIEW

Richter's transformation (RT) occurs when chronic (CLL) transforms into an aggressive lymphoma. Despite improvements in the treatment of CLL, prognosis for RT remains poor. Here, we review current literature of RT, with a focus on novel treatment options.

RECENT FINDINGS

Efforts are underway to improve outcomes for patients with RT. While small molecule inhibitors have limited efficacy as monotherapy, recent developments combining them with chemo-immunotherapy show promise. Studies exploring the use of cellular therapies including chimeric antigen receptor T-cells and bispecific antibodies are ongoing. The current treatment paradigm for RT is to enroll these patients on a clinical trial when available, together with consultation for a consolidative allogeneic stem cell transplant. Trials investigating novel combinations and cellular therapy are ongoing. Determining predictive variables of transformation is imperative to design studies that allow for early identification and intervention for patients with RT.

摘要

目的综述

慢性淋巴细胞白血病(CLL)转化为侵袭性淋巴瘤即为里希特转化(RT)。尽管 CLL 的治疗已有改善,但 RT 的预后仍然较差。在此,我们对 RT 的现有文献进行综述,重点介绍新的治疗选择。

最近的发现

目前正在努力改善 RT 患者的预后。虽然小分子抑制剂作为单一疗法的疗效有限,但最近将它们与化疗免疫疗法联合使用的进展显示出了希望。正在探索使用嵌合抗原受体 T 细胞和双特异性抗体等细胞疗法的研究。目前 RT 的治疗模式是在有条件时让这些患者参加临床试验,并咨询同种异体干细胞移植的巩固治疗。正在进行新的联合治疗和细胞治疗的试验。确定转化的预测变量对于设计允许早期识别和干预 RT 患者的研究至关重要。

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