{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T10:29:28Z","timestamp":1794047368780,"version":"4.8.0"},"reference-count":26,"publisher":"Ferrata Storti Foundation (Haematologica)","issue":"11","license":[{"start":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T00:00:00Z","timestamp":1601856000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["haematol"],"abstract":"<jats:p>Chronic lymphocytic leukemia (CLL) patients who develop Hodgkin lymphoma (HL) have limited survival. No current therapeutic standard of care exists. We conducted a multi-center retrospective study of patients with Hodgkin transformation (HT) of CLL. Clinicobiologic characteristics, treatment type, and survival outcomes were analyzed and compared with historic case series. Ninety-four patients were identified. Median age at HT was 67 years (range, 38-85). Median time from CLL diagnosis to HT was 5.5 years (range, 0-20.2). Prior to HT, patients received a median of two therapies for CLL (range, 0-12). As initial therapy for HT, 61% (n=62) received ABVD-based regimens (adriamycin, bleomycin, vinblastine, and dacarbazine). Seven (7%) patients received hematopoietic cell transplantation (HCT) while in first complete remission (CR1). The median number of treatments for HT per patient was one (range, 0-5) with 59 (61%) patients only receiving one line of therapy. After HT, patients had a median follow-up of 1.6 years (range, 0-15.1). Two-year overall survival (OS) after HT diagnosis was 72% (95% Confidence Interval: 62-83). The patients who received standard ABVD-based therapy had a median OS of 13.2 years. Although limited by small sample size, the patients who underwent HCT for HT in CR1 had a similar 2-year OS (n=7; 67%) compared to patients who did not undergo HCT for HT in CR1 (n=87; 72%; P=0.46). In this multi-center study, HT patients treated with ABVD-based regimens had prolonged survival supporting the use of these regimens as standard of care for these patients.<\/jats:p>","DOI":"10.3324\/haematol.2020.256388","type":"journal-article","created":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T14:43:12Z","timestamp":1601908992000},"page":"2845-2852","source":"Crossref","is-referenced-by-count":34,"title":["Hodgkin lymphoma arising in patients with chronic lymphocytic leukemia: outcomes from a large multi-center collaboration"],"prefix":"10.3324","volume":"106","author":[{"given":"Deborah M.","family":"Stephens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Boucher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Kander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer A.","family":"Parikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin M.","family":"Parry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazyar","family":"Shadman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Pagel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Cooperrider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Rhodes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Mato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Hill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameh","family":"Gaballa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey","family":"Danilov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tycel","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle M.","family":"Brander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonali M.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Davids","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha J.","family":"Glenn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Byrd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1856","published-online":{"date-parts":[[2020,10,5]]},"reference":[{"key":"30814","doi-asserted-by":"crossref","unstructured":"Tsimberidou AM, O'Brien S, Khouri I. Clinical outcomes and prognostic factors in patients with Richter's syndrome treated with chemotherapy or chemoimmunotherapy with or without stem-cell transplantation. J Clin Oncol. 2006; 24(15):2343-2351.","DOI":"10.1200\/JCO.2005.05.0187"},{"key":"30815","doi-asserted-by":"crossref","unstructured":"Parikh SA, Habermann TM, Chaffee KG. Hodgkin transformation of chronic lymphocytic leukemia: incidence, outcomes, and comparison to de novo Hodgkin lymphoma. Am J Hematol. 2015; 90(4):334-338.","DOI":"10.1002\/ajh.23939"},{"key":"30816","doi-asserted-by":"crossref","unstructured":"Tsimberidou AM, O'Brien S, Kantarjian HM. Hodgkin transformation of chronic lymphocytic leukemia: the M. D. Anderson Cancer Center experience. Cancer. 2006; 107(6):1294-1302.","DOI":"10.1002\/cncr.22121"},{"key":"30817","doi-asserted-by":"crossref","unstructured":"Bockorny B, Codreanu I, Dasanu CA. Hodgkin lymphoma as Richter transformation in chronic lymphocytic leukaemia: a retrospective analysis of world literature. Br J Haematol. 2012; 156(1):50-66.","DOI":"10.1111\/j.1365-2141.2011.08907.x"},{"key":"30818","doi-asserted-by":"crossref","unstructured":"Ramchandren R, Advani RH, Ansell SM. Brentuximab vedotin plus chemotherapy in North American patients with newly diagnosed stage III or IV Hodgkin lymphoma. Clin Cancer Res. 2019; 25(6):1718-1726.","DOI":"10.1158\/1078-0432.CCR-18-2435"},{"key":"30819","doi-asserted-by":"crossref","unstructured":"Evens AM, Helenowski I, Ramsdale E. A retrospective multicenter analysis of elderly Hodgkin lymphoma: outcomes and prognostic factors in the modern era. Blood. 2012; 119(3):692-695.","DOI":"10.1182\/blood-2011-09-378414"},{"key":"30820","doi-asserted-by":"crossref","unstructured":"Evens AM, Hong F, Gordon LI. The efficacy and tolerability of adriamycin, bleomycin, vinblastine, dacarbazine and Stanford V in older Hodgkin lymphoma patients: a comprehensive analysis from the North American intergroup trial E2496. Br J Haematol. 2013; 161(1):76-86.","DOI":"10.1111\/bjh.12222"},{"key":"30821","doi-asserted-by":"crossref","unstructured":"Parikh SA, Rabe KG, Ding W. Hodgkin Transformation of chronic lymphocytic leukemia (CLL): Mayo Clinic experience. Blood. 2013; 122(21):1642-1642.","DOI":"10.1182\/blood.V122.21.1642.1642"},{"key":"30822","doi-asserted-by":"crossref","unstructured":"Fayad L, Robertson LE, O'Brien S. Hodgkin's disease variant of Richter's syndrome: experience at a single institution. Leuk Lymphoma. 1996; 23(3-4):333-337.","DOI":"10.3109\/10428199609054836"},{"key":"30823","doi-asserted-by":"crossref","unstructured":"Kazmierczak M, Kroll-Balcerzak R, Balcerzak A. Hodgkin lymphoma transformation of chronic lymphocytic leukemia: cases report and discussion. Med Oncol. 2014; 31(1):800.","DOI":"10.1007\/s12032-013-0800-8"},{"key":"30824","doi-asserted-by":"crossref","unstructured":"Kharfan-Dabaja MA, Kumar A, Hamadani M. Clinical practice recommendations for use of allogeneic hematopoietic cell transplantation in chronic lymphocytic leukemia on behalf of the Guidelines Committee of the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 2016; 22(12):2117-2125.","DOI":"10.1016\/j.bbmt.2016.09.013"},{"key":"30825","doi-asserted-by":"crossref","unstructured":"Hasenclever D, Diehl V. A prognostic score for advanced Hodgkin's disease. International Prognostic Factors Project on Advanced Hodgkin's Disease. N Engl J Med. 1998; 339(21):1506-1514.","DOI":"10.1056\/NEJM199811193392104"},{"key":"30826","doi-asserted-by":"crossref","unstructured":"Tsimberidou AM, O'Brien SM, Cortes JE. Phase II study of fludarabine, cytarabine (Ara-C), cyclophosphamide, cisplatin and GM-CSF (FACPGM) in patients with Richter's syndrome or refractory lymphoproliferative disorders. Leuk Lymphoma. 2002; 43(4):767-772.","DOI":"10.1080\/10428190290016872"},{"key":"30827","doi-asserted-by":"crossref","unstructured":"Robertson LE, Pugh W, O'Brien S. Richter's syndrome: a report on 39 patients. J Clin Oncol. 1993; 11(10):1985-1989.","DOI":"10.1200\/JCO.1993.11.10.1985"},{"key":"30828","doi-asserted-by":"crossref","unstructured":"Dabaja BS, O'Brien SM, Kantarjian HM. Fractionated cyclophosphamide, vincristine, liposomal daunorubicin (daunoXome), and dexamethasone (hyperCVXD) regimen in Richter's syndrome. Leuk Lymphoma. 2001; 42(3):329-337.","DOI":"10.3109\/10428190109064589"},{"key":"30829","doi-asserted-by":"crossref","unstructured":"Tsimberidou AM, Kantarjian HM, Cortes J. Fractionated cyclophosphamide, vincristine, liposomal daunorubicin, and dexamethasone plus rituximab and granulocyte- macrophage-colony stimulating factor (GM-CSF) alternating with methotrexate and cytarabine plus rituximab and GM-CSF in patients with Richter syndrome or fludarabine- refractory chronic lymphocytic leukemia. Cancer. 2003; 97(7):1711-1720.","DOI":"10.1002\/cncr.11238"},{"key":"30830","doi-asserted-by":"crossref","unstructured":"Harousseau JL, Flandrin G, Tricot G, Brouet JC, Seligmann M, Bernard J. Malignant lymphoma supervening in chronic lymphocytic leukemia and related disorders. Richter's syndrome: a study of 25 cases. Cancer. 1981; 48(6):1302-1308.","DOI":"10.1002\/1097-0142(19810915)48:6<1302::AID-CNCR2820480609>3.0.CO;2-Q"},{"key":"30831","doi-asserted-by":"crossref","unstructured":"Rossi D, Cerri M, Capello D. Biological and clinical risk factors of chronic lymphocytic leukaemia transformation to Richter syndrome. Br J Haematol. 2008; 142(2):202-215.","DOI":"10.1111\/j.1365-2141.2008.07166.x"},{"key":"30832","doi-asserted-by":"crossref","unstructured":"Wierda WG, Byrd JC, Abramson JS. NCCN Guidelines insights: chronic lymphocytic leukemia\/small lymphocytic lymphoma, version 2.2019. J Natl Compr Canc Netw. 2019; 17(1):12-20.","DOI":"10.6004\/jnccn.2019.0002"},{"key":"30833","doi-asserted-by":"crossref","unstructured":"Xiao W, Chen WW, Sorbara L. Hodgkin lymphoma variant of Richter transformation: morphology, Epstein-Barr virus status, clonality, and survival analysiswith comparison to Hodgkin-like lesion. Hum Pathol. 2016; 55:108-116.","DOI":"10.1016\/j.humpath.2016.04.019"},{"key":"30834","doi-asserted-by":"crossref","unstructured":"Rossi D, Spina V, Deambrogi C. The genetics of Richter syndrome reveals disease heterogeneity and predicts survival after transformation. Blood. 2011; 117(12):3391-3401.","DOI":"10.1182\/blood-2010-09-302174"},{"key":"30835","doi-asserted-by":"crossref","unstructured":"Brenner H, Gondos A, Pulte D. Ongoing improvement in long-term survival of patients with Hodgkin disease at all ages and recent catch-up of older patients. Blood. 2008; 111(6):2977-2983.","DOI":"10.1182\/blood-2007-10-115493"},{"key":"30836","doi-asserted-by":"crossref","unstructured":"Byrd JC, Furman RR, Coutre SE. Targeting BTK with ibrutinib in relapsed chronic lymphocytic leukemia. N Engl J Med. 2013; 369(1):32-42.","DOI":"10.1056\/NEJMoa1215637"},{"key":"30837","doi-asserted-by":"crossref","unstructured":"Burger JA, Tedeschi A, Barr PM. Ibrutinib as initial therapy for patients with chronic lymphocytic leukemia. N Engl J Med. 2015; 373(25):2425-2437.","DOI":"10.1056\/NEJMoa1509388"},{"key":"30838","doi-asserted-by":"crossref","unstructured":"Woyach JA, Ruppert AS, Guinn D. BTK. J Clin Oncol. 2017; 35(13):1437-1443.","DOI":"10.1200\/JCO.2016.70.2282"},{"key":"30839","doi-asserted-by":"crossref","unstructured":"Ohno T, Smir BN, Weisenburger DD, Gascoyne RD, Hinrichs SD, Chan WC. Origin of the Hodgkin\/Reed-Sternberg cells in chronic lymphocytic leukemia with &quot;Hodgkin's transformation&quot;. Blood. 1998; 91(5):1757-1761.","DOI":"10.1182\/blood.V91.5.1757"}],"container-title":["Haematologica"],"original-title":[],"link":[{"URL":"https:\/\/haematologica.org\/article\/download\/haematol.2020.256388\/72461","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/haematologica.org\/article\/download\/haematol.2020.256388\/73791","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/haematologica.org\/article\/download\/10036\/72461","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T09:58:18Z","timestamp":1794045498000},"score":1,"resource":{"primary":{"URL":"https:\/\/haematologica.org\/article\/view\/haematol.2020.256388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,5]]},"references-count":26,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,1]]}},"URL":"https:\/\/doi.org\/10.3324\/haematol.2020.256388","relation":{},"ISSN":["1592-8721","0390-6078"],"issn-type":[{"value":"1592-8721","type":"electronic"},{"value":"0390-6078","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10,5]]}}}