RICHTER SYNDROME WITH EMPHASIS ON LARGE-CELL NON-HODGKIN-LYMPHOMA IN PREVIOUSLY UNRECOGNIZED SUBCLINICAL CHRONIC LYMPHOCYTIC-LEUKEMIA

The authors report seven cases of Richter's syndrome, i.e. of large-ce ll non-Hodgkin's lymphoma (NHL) arising in association with chronic ly mphocytic leukemia (CLL). Six patients had the recently recognized var iant of this syndrome, occurring in patients with previously undiagnos ed subclinical CLL. All patients were treated with aggressive chemothe rapy and a complete response of large cell NHL was achieved in 4/7. A complete response of NHL was observed in 3 out of 6, and a partial res ponse in 2/6 patients with simultaneous occurrence of subclinical CLL and large cell NHL (response rate 5/6). Our findings might suggest tha t patients with Richter syndrome occurring in previously undiagnosed s ubclinical CLL could represent a better prognostic group in the overal l population of patients with large cell NHL transformation of CLL.