{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:39:01Z","timestamp":1791517141669,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T00:00:00Z","timestamp":1666224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Chronic lymphocytic leukemia (CLL) transformation to aggressive lymphoma, known as Richter's Transformation (RT), has a dismal prognosis. There are limited data evaluating risk of RT in patients treated with ibrutinib. We performed a retrospective analysis to determine prognostic variables associated with development of RT and overall survival (OS) at progression after treatment with ibrutinib. We identified 559 patients with CLL treated with ibrutinib from 2010\u20132019. After a median follow\u2010up of 44.5\u00a0months from ibrutinib start, 179 patients progressed and were included in our analysis. After a median follow\u2010up of 20.8\u00a0months from progression, 54 out of 179 patients developed RT. Progression on treatment (hazard ratio [HR] 4.01 [1.60\u201310.00], <jats:italic>p<\/jats:italic>\u00a0=\u2009.003), higher LDH (HR 1.80 for 2\u2010fold increase [1.33\u20132.43], <jats:italic>p<\/jats:italic>\u00a0=\u2009.0001), and lymphadenopathy without lymphocytosis (HR 2.88 [1.15\u20137.20], <jats:italic>p<\/jats:italic>\u00a0=\u2009.02) were independent prognostic variables for the development of RT at progression. Progression with lymphadenopathy without lymphocytosis continued to be an independent prognostic variable of worse OS post\u2010progression. In a subset analysis of 50 patients who obtained a PET\u2010CT at progression, the median SUV<jats:sub>max<\/jats:sub> for patients who would develop RT was 15.2 (<jats:italic>n<\/jats:italic>\u00a0=\u200930, range: 4.0\u201346.3) versus those patients who did not develop RT with a SUV<jats:sub>max<\/jats:sub> of 7.7 (<jats:italic>n<\/jats:italic>\u00a0=\u200920, range: 2.3\u201327.2) (<jats:italic>p<\/jats:italic>\u00a0=\u2009.0030). Median OS from date of RT was 4.0\u00a0months, suggesting that prognosis for RT remains poor. A lymph node biopsy to rule out RT should be considered in patients who received ibrutinib who progress on treatment, have an elevated LDH, or progress with lymphadenopathy without lymphocytosis.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p>","DOI":"10.1002\/ajh.26755","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T02:58:11Z","timestamp":1665457091000},"page":"56-65","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Patient characteristics that predict Richter's transformation in patients with chronic lymphocytic leukemia treated with ibrutinib"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4891-6144","authenticated-orcid":false,"given":"Adam S.","family":"Kittai","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology The Ohio State University  Columbus Ohio 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