Interesting unusual heme website

[LADoc00]

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Was messing around on the internet attempting to answer the ? of whether the original CLL immunophenotype (CD19/CD5/CD23+) is retained or altered with transformation to either CLL/PLL or Richter's and found this interesting site:

http://cll.acor.org/Professors'%20posts.htm

 

[pathdoc68]

Some claim that CLL never transforms to PLL. As CLL evolves one can have increased prolymphocytes - but that does not make it PLL. Even when CLL has transformed to a large cell lymphoma it frequently retains immunophenotypic vestiges of its origin (detetected by flow) esp. dim 20

 

[LADoc00]

Some claim that CLL never transforms to PLL. As CLL evolves one can have increased prolymphocytes - but that does not make it PLL. Even when CLL has transformed to a large cell lymphoma it frequently retains immunophenotypic vestiges of its origin (detetected by flow) esp. dim 20

My bad, by CLL/PLL I meant CLL with increased prolymphocytes. Indeed PLL is its own entity with a phenotype different than CLL(namely it is CD5 negative as well as CD23-).

In about half the cases of large cell transformation, actually the clone is different than the original CLL, thus the "transformation" designation is something of a misnomer. Likely some of these supposed transformations are resultant from an environment of secondary immunosuppresion brought on by the CLL. Similar mechanism to PTLDs or DLBCLs in the AIDS setting, I would imagine.

 

[pathstudent]

I thought Richters Syndrome simply meant the development of a more aggressive lymphoid neoplasm in a CLL/SLL patient.

For instance, developing ALCL or ALL or Hodgkins qualifies as transformation to Richters syndrome in CLL. Surely those transformation have a very different phenotype. But maybe I am misunderstanding the question. And I haven't checked out the "interesting site".