{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T11:41:07Z","timestamp":1771069267835,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,9,2]],"date-time":"2014-09-02T00:00:00Z","timestamp":1409616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:p>Richter's syndrome (RS) is the rare development of an aggressive lymphoid malignancy in a patient with pre\u2010existing chronic lymphocytic leukemia (CLL). Data on RS is sparse and mostly derived from case reports or small series of patients and only a few larger cohorts have been published. The purpose of this large retrospective study was to summarize our national experience with RS in CLL, examine possible risk factors, and analyze relevant demographic, laboratory and clinical parameters, including results of therapy and outcome. We first evaluated data obtained from 119 patients with RS diagnosed during 1971\u20132010 from 12 medical centers in Israel. The final cohort summarized consisted of 81 patients with RS who developed only diffuse large B\u2010cell lymphoma (DLBCL) after exclusion all cases with insufficient data and those who were not DLBCL. Median overall survival from time of diagnosis of RS was 8 months; after applying the Richter score, patients could be stratified into three prognostic groups, while all other clinical and laboratory parameters evaluated had no prognostic significance. Prior therapy for CLL had no impact on RS survival (<jats:italic>P<\/jats:italic>\u2009=\u20090.8) and patients with therapy \u201cna\u00efve\u201d RS and those who had already received chemotherapy prior to developing RS, had the same survival. The addition of rituximab to chemotherapy for RS improved 2 years overall survival from 19% in the chemotherapy alone arm to 42% (<jats:italic>P<\/jats:italic> value of 0.001). Although prognosis of patients with RS remains dismal, this retrospective observation provides support for the use of chemo\u2010immunotherapy in DLBCL\u2010RS. Am. J. Hematol. 89:E218\u2013E222, 2014. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23826","type":"journal-article","created":{"date-parts":[[2015,1,29]],"date-time":"2015-01-29T23:11:56Z","timestamp":1422573116000},"source":"Crossref","is-referenced-by-count":31,"title":["Richter's transformation to diffuse large B\u2010cell lymphoma: A retrospective study reporting clinical data, outcome, and the benefit of adding rituximab to chemotherapy, from the <scp>I<\/scp>sraeli <scp>CLL<\/scp><scp>S<\/scp>tudy <scp>G<\/scp>roup"],"prefix":"10.1002","volume":"89","author":[{"given":"Tamar","family":"Tadmor","sequence":"first","affiliation":[{"name":"Hematology Unit, Bnai\u2010Zion Medical Center Haifa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lev","family":"Shvidel","sequence":"additional","affiliation":[{"name":"Department of Hematology Kaplan Medical Center Rehovot"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osnat","family":"Bairey","sequence":"additional","affiliation":[{"name":"Department of Hematology Rabin Medical Center, Petah\u2010Tikva and Sackler Faculty of Medicine, Tel Aviv University Tel Aviv"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neta","family":"Goldschmidt","sequence":"additional","affiliation":[{"name":"Department of Hematology Hadassah University Hospital Jerusalem"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Ruchlemer","sequence":"additional","affiliation":[{"name":"Hematology Department Shaare Zedek Medical Center Jerusalem"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riva","family":"Fineman","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation Rambam Health Care Campus Haifa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Rahimi\u2010Levene","sequence":"additional","affiliation":[{"name":"Hematology Unit, Assaf Harofeh Medical Center Zerifin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yair","family":"Herishanu","sequence":"additional","affiliation":[{"name":"Department of Hematology Sourasky Medical Center Tel\u2010Aviv"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Yuklea","sequence":"additional","affiliation":[{"name":"Hematology Department Meir Medical Center Kfar\u2010Saba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariela","family":"Arad","sequence":"additional","affiliation":[{"name":"Hematology department Sanz Medical Center Laniado Hospital Natanya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariel","family":"Aviv","sequence":"additional","affiliation":[{"name":"Hematology Unit Afula Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Polliack","sequence":"additional","affiliation":[{"name":"Department of Hematology Hadassah University Hospital Jerusalem"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"On behalf of the Israeli CLL Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,9,2]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"285","article-title":"Generalized reticular cell sarcoma of lymph nodes associated with lymphatic leukemia","volume":"4","author":"Richter MN","year":"1928","journal-title":"Am J Pathol"},{"key":"e_1_2_5_3_1","first-page":"637","article-title":"[3 cases of acute transformation of chronic lymphocytic hemopathies]","volume":"6","author":"Lortholary P","year":"1966","journal-title":"Nouvelle revue francaise d'hematologie"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20773"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12458"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-11-516229"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-01-0016"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70002-0"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.09.137"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61381-5"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2012.740670"},{"key":"e_1_2_5_12_1","first-page":"785","article-title":"Hodgkin's variant of richter transformation in chronic lymphocytic leukemia; 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