Richter's transformation: Transforming the clinical landscape

Barrett, A.; Appleby, N.; Dreau, H.; Fox, C.P.; Munir, T.; Eyre, T.A.

Abstract

Richter transformation (RT) represents an aggressive histological transformation from chronic lymphocytic leukaemia, most often to a large B cell lymphoma. It is characterised by chemo-resistance and subsequent short survival. Drug development has struggled over recent years in light of the aggressive kinetics of the disease, lack of pivotal registrational trials and relative rarity of the phenomenon. In this review we will highlight the diagnostic and therapeutic challenges of managing patients with RT as well as taking a look to the future therapeutic landscape. Highly active therapies developed across B cell malignancies are starting to impact this field, with T-cell activation therapies (CAR-T, bispecific antibodies), antibody-drug conjugates, and novel small molecule inhibitor combinations (e.g. BTKi-BCL2i) being actively studied. We will highlight the data supporting these developments and look to the studies to come to provide hope for patients suffering from this devastating disease.

Citation

Barrett, A., Appleby, N., Dreau, H., Fox, C., Munir, T., & Eyre, T. (2024). Richter's transformation: Transforming the clinical landscape. Blood Reviews, 64, Article 101163. https://doi.org/10.1016/j.blre.2023.101163

• Journal Article Type: Review
• Acceptance Date: Dec 8, 2023
• Online Publication Date: Dec 10, 2023
• Publication Date: 2024-03
• Deposit Date: Feb 9, 2024
• Publicly Available Date: Dec 11, 2024
• Journal: Blood Reviews
• Print ISSN: 0268-960X
• Electronic ISSN: 1532-1681
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 64
• Article Number: 101163
• DOI: https://doi.org/10.1016/j.blre.2023.101163
• Keywords: Hodgkin lymphoma, Chronic lymphocytic leukaemia, Diffuse large B cell lymphoma, Richter's transformation
• Public URL: https://nottingham-repository.worktribe.com/output/29257323
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0268960X23001339?via%3Dihub