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Jennifer R. Brown, MD, PhD


Do Differences Among CLL Variants Affect Treatment Outcomes?

By: Victoria Kuhr, BA
Posted: Wednesday, March 30, 2022

Patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) who were treated with Hodgkin-directed therapy appear to have a significantly higher survival rate compared with patients treated with CLL-directed therapy. Rebecca L. King, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues reported that survival differences may be due to the phenotype expressions in each cancer reacting differently when observed on a biologic continuum. These study findings were published in the Blood Cancer Journal.

“Our clinical and pathologic findings suggest a biological continuum for chronic lymphocytic leukemia,” said the authors. “These finding emphasize the importance of accurately diagnosing and treating patients with directed therapies.”

The Mayo Clinic Chronic Lymphocytic Leukemia Database, Mayo Clinic Lymphoma Database, and Pathology Archives were searched for patient data (1990–2020). Patients with CLL/SLL and either classic Hodgkin lymphoma (CLL-HL) or CLL/SLL with Reed-Sternberg–like (CLL-HRS) cells were included in the study. Three independent hematologists rereviewed the pathology materials for a consensus to enroll each patient.

The study comprised 51 patients with CLL/SLL and either CLL-HRS or CLL-HL. Among these patients, 29 were diagnosed with CLL-HL, 15 were diagnosed with CLL-HRS, and 2 had biopsies in which distinct areas of CLL-HRS and CLL-HL were present in the same tissue at initial diagnosis. The median age at the time of CLL-HL or CLL-HRS transformation diagnosis was 72 years, and there was a male predominance in both groups (71% in CLL-HL and 87% in CLL-HRS). The median time from CLL to CLL-HL transformation was 6.6 years and CLL to CLL-HRS was 4.9 years. The median overall survival of patients with CLL-HRS was 17.5 months compared with 33.5 months for patients with CLL-HL. Among patients with CLL-HRS, those who received Hodgkin-directed therapy had a significantly longer median overall survival (57 months) than those who received CLL-directed therapy (8.4 months).

Disclosure: For full disclosures of the study authors, visit

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