title: Hodgkin's type of Richter's syndrome in familial chronic lymphocytic leukemia treated with cladribine and cyclophosphamide.
abstract: Second malignancies are frequent complications in patients with chronic lymphocytic leukemia (CLL). Hodgkin's disease (HD) has been observed in approximately 0.5% of the patients with CLL and is known as Hodgkin's type Richter's syndrome (H-RS). We present a 64-year-old male patient with a familial history of CLL who developed H-RS in abdominal lymph nodes 6 years after CLL diagnosis and 18 months after treatment with cladribine (2-CdA) and cyclophosphamide. HD was diagnosed by fine needle aspiration. The disease was refractory to treatment with two courses of CHOP and three courses of ABVD chemotherapy. In the current literature we found case reports of only 6 patients with H-RS who were treated with fludarabine (FA) before transformation, and, to our knowledge the presented patient is the first to develop H-RS after treatment with 2-CdA combined with cyclophosphamide. He is also the first published patient with familial CLL in whom this complication developed.
authors.affiliation: Department of Hematology, Medical University of Łódź, Pabianicka 62, 93-513 Łódź, Poland. robaktad@csk.am.lodz.pl
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Robak
authors.forename: Anna
authors.initials: A
authors.lastname: Szmigielska-Kapłon
authors.forename: Piotr
authors.initials: P
authors.lastname: Smolewski
authors.forename: Ewa
authors.initials: E
authors.lastname: Wawrzyniak
authors.forename: Anna
authors.initials: A
authors.lastname: Korycka
authors.forename: Jacek
authors.initials: J
authors.lastname: Bartkowiak
authors.forename: Radzisław
authors.initials: R
authors.lastname: Kordek
mesh_terms: D000008:Abdominal Neoplasms / Q000209:etiology / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002471:Cell Transformation, Neoplastic; D017338:Cladribine / Q000009:adverse effects* / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D005192:Family Health; D004854:Herpesvirus 4, Human; D006689:Hodgkin Disease / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology / Q000821:virology; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000209:etiology / Q000473:pathology; D013577:Syndrome
chemical_list: D017338:Cladribine; D003520:Cyclophosphamide