{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:52:16Z","timestamp":1790887936645,"version":"4.1.0"},"reference-count":21,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Richter transformation (RT) is defined as the histologic transformation of Chronic Lymphocytic Leukemia (CLL) to either diffuse large B-cell lymphoma or Hodgkin lymphoma. Transformation into lymphoproliferative neoplasms with plasmablastic differentiation is exceptionally rare and poorly characterized. Case Presentation: We present the first case of a patient with CLL evolving into plasmablastic myeloma (PBM). A 62-year-old man with previously treated CLL developed thrombocytopenia and rapidly progressive acute kidney injury. Serum electrophoresis showed new IgA-\u03bb protein (2.2 g\/L) with \u03bb and \u03ba light chains at 3445.4 and 7.3 mg\/L. Bone marrow examination showed extensive infiltration (&gt;95%) by plasmablasts and mature plasma cells, with a consistent immunophenotype (CD38+, CD138+, MUM1+, CD19\u2212, CD20\u2212). In situ hybridization with EBER was negative. Mutation assessment by NGS demonstrated a TP53 mutation and FISH prob panel revealed a new del17p. Clonal relatedness was confirmed by shared IGHV somatic hypermutation using NGS. The patient was primary refractory to frontline myeloma therapy with Dara-VRd and succumbed rapidly to his disease. Discussion: This case illustrates an exceptionally rare form of RT. Recognition and incorporation in new classifications of plasmablastic RT as a distinct entity is critical, as its biology and resistance profile differ from classical RT.<\/jats:p>","DOI":"10.3390\/curroncol32100550","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T14:16:29Z","timestamp":1759241789000},"page":"550","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["From Chronic Lymphocytic Leukemia to Plasmablastic Myeloma: Beyond the Usual Richter Transformation"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9281-8015","authenticated-orcid":false,"given":"Mathias","family":"Castonguay","sequence":"first","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-France","family":"Gagnon","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9912-0229","authenticated-orcid":false,"given":"Alexandre","family":"Le Nguyen","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafik","family":"Terra","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah-Jeanne","family":"Pilon","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"},{"name":"Pathology and Cellular Biology Department, Maisonneuve-Rosemont Hospital, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guylaine","family":"L\u00e9pine","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"LeBlanc","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7716-6864","authenticated-orcid":false,"given":"Jean","family":"Roy","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Cohen","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Fleury","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigina","family":"Mollica","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Veilleux","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-S\u00e9bastien","family":"Claveau","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Cell Therapy Institute, H\u00f4pital Maisonneuve-Rosemont, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H1T 2M4, Canada"},{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1038\/s41375-022-01620-2","article-title":"The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms","volume":"36","author":"Alaggio","year":"2022","journal-title":"Leukemia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.canep.2019.04.002","article-title":"Richter syndrome epidemiology in a large population based chronic lymphocytic leukemia cohort from Norway","volume":"60","author":"Lenartova","year":"2019","journal-title":"Cancer Epidemiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2761","DOI":"10.1182\/blood-2018-01-791376","article-title":"Biology and treatment of Richter syndrome","volume":"131","author":"Rossi","year":"2018","journal-title":"Blood"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"407","DOI":"10.5858\/arpa.2021-0117-RA","article-title":"Lymphoproliferative Neoplasms with Plasmablastic Morphology","volume":"146","author":"Zhou","year":"2021","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Li, J.-W., Peng, H.-L., Zhou, X.-Y., and Wang, J.-J. (2024). Plasmablastic lymphoma: Current knowledge and future directions. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1354604"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1182\/blood.V65.2.305.305","article-title":"Multiple myeloma: Significance of plasmablastic subtype in morphological classification","volume":"65","author":"Greipp","year":"1985","journal-title":"Blood"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1136\/jclinpath-2016-204294","article-title":"Plasmablastic lymphoma versus plasmablastic myeloma: An ongoing diagnostic dilemma","volume":"70","author":"Ahn","year":"2017","journal-title":"J. Clin. Pathol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s00428-022-03342-3","article-title":"Plasmablastic myeloma in Taiwan frequently presents with extramedullary and extranodal mass mimicking plasmablastic lymphoma","volume":"481","author":"Chen","year":"2022","journal-title":"Virchows Arch."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1111\/apm.12411","article-title":"Clinicopathological features of plasmablastic multiple myeloma: A population-based cohort","volume":"123","author":"Preiss","year":"2015","journal-title":"APMIS"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1097\/PAS.0000000000001459","article-title":"Genetic Basis of Extramedullary Plasmablastic Transformation of Multiple Myeloma","volume":"44","author":"Liu","year":"2020","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/PAP.0000000000000253","article-title":"Lymphoid Neoplasms With Plasmablastic Differentiation: A Comprehensive Review and Diagnostic Approaches","volume":"27","author":"Chen","year":"2019","journal-title":"Adv. Anat. Pathol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2745","DOI":"10.1182\/blood-2017-09-806398","article-title":"iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL","volume":"131","author":"Hallek","year":"2018","journal-title":"Blood"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1038\/sj.leu.2403202","article-title":"Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: Report of the BIOMED-2 Concerted Action BMH4-CT98-3936","volume":"17","author":"Langerak","year":"2003","journal-title":"Leukemia"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/sj.leu.2404457","article-title":"ERIC recommendations on IGHV gene mutational status analysis in chronic lymphocytic leukemia","volume":"21","author":"Ghia","year":"2006","journal-title":"Leukemia"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/bjh.15458","article-title":"Outcomes of patients with simultaneous diagnosis of chronic lymphocytic leukaemia\/small lymphocytic lymphoma and multiple myeloma","volume":"185","author":"Ailawadhi","year":"2019","journal-title":"Br. J. Haematol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1038\/s41408-023-00784-z","article-title":"Risk of second primary malignancies in patients with chronic lymphocytic leukemia: A population-based study in the Netherlands, 1989\u20132019","volume":"13","author":"Levin","year":"2023","journal-title":"Blood Cancer J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1111\/bjh.15777","article-title":"Second primary cancers in patients with acute lymphoblastic, chronic lymphocytic and hairy cell leukaemia","volume":"185","author":"Zheng","year":"2019","journal-title":"Br. J. Haematol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3197","DOI":"10.1038\/s41375-020-0987-6","article-title":"Second cancer incidence in CLL patients receiving BTK inhibitors","volume":"34","author":"Bond","year":"2020","journal-title":"Leukemia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1038\/s41375-025-02666-8","article-title":"Richter transformation in diffuse large B-cell lymphoma in patients with chronic lymphocytic leukemia receiving ibrutinib: Risk factors and outcomes","volume":"39","author":"Pepe","year":"2025","journal-title":"Leukemia"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1002\/ajh.26755","article-title":"Patient characteristics that predict Richter\u2019s transformation in patients with chronic lymphocytic leukemia treated with ibrutinib","volume":"98","author":"Kittai","year":"2022","journal-title":"Am. J. Hematol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1002\/jha2.771","article-title":"Molecular characterization and clonal evolution in Richter transformation: Insights from a case of plasmablastic lymphoma (RT-PBL) arising from chronic lymphocytic leukaemia (CLL) and review of the literature","volume":"4","author":"Ramsey","year":"2023","journal-title":"eJHaem"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/10\/550\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T15:00:28Z","timestamp":1759244428000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/10\/550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":21,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["curroncol32100550"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32100550","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}