Differentiation between Richters and a parallel lymphoma

[Guest guest]

To distinguish between parallel disease and transformation

it is necessary to sequence the ighv genes of the cll and

diffuse lymphoma cells. The test for tp53 is a fish test.

Terry Hamblin

Marilyn wrote:

/message/15499

[Guest guest]

Am still waiting for results of Lymph Node biopsy. Last

week's BMB showed both Cll and Large Diffuse Lymphoma cells.

Spoke with my heme/onc today. I'm getting uneasy. I asked

him if I might have parallel diseases. He said what's that?

He said it did not matter because the treatment was the

same, the only difference is how one responds to Treatment.

I made him aware of Dr.Hamblin's message concerning R.T.

" at least half of RT have a del17p/T53. " He is willing to

work with me if that means he will need to order more tests

on the biopsy materials. What is the test to use to

determine " deletions "

I dont want CHOP R if high doses of high density prednisone

and Rituxan is better in my particular case. What tests

would be helpful in determining where to go from here?

Does anyone know how to distinguish between Parallel

diseases or a transformation?

Always appreciative,

Marilyn Barbera

[Guest guest]

Marilyn,

I shared my husband's story a day or so ago:

/message/15485

Two weeks prior to my husband's Richter'sTransformation, his

wbc was about 75,000. Interestingly, it dropped to 56,000 in

the ER. The transformation (DLBCL) was contained in his

spleen according to the oncologist. He had both CLL and

DLBCL. The R-CHOP put both in remission.

According to my understanding, Richter's Transformation is

confirmed via biopsy. In my husband's case that was not an

option the oncologist recommended for several reasons.

However, all the other circumstantial evidence was there...

extremely elevated LDH levels, suspicious lesions that lit-

up on the PET scan, and sudden onset of B symptoms.

The doctor said the biopsy was irrelevant in his situation

as the immediate course of action that was needed regardless

was to proceed with R-CHOP as soon as possible. My husband

went from ER to chemo within 2-3 days. It was the right

decision for my husband and we have no regrets.

We know the CLL will eventually return. Hopefully, the DLBCL

will not. We are in contact with a few other CLL patients

who have had a similar experience with Richter's and they

continue to enjoy remissions lasting longer than the grim

statistics cited as well as their lives.

Best wishes for whatever you decide,

Stella