What is the Incidence of Richter's?

Traditional estimates of Richter's transformation range from 1% to 8%. The CLL clone can transform into an acute lymphoma, similar to a diffuse B cell lymphoma. Hodgkin's disease can also arise in CLL patients. Transformation occurs almost exclusively in the unmutated patient.

The DBCL or Hodgkin's can also arise 'de novo', which means it just pops up, and it's unrelated to the CLL cell. In other words, it doesn't transform from the CLL cells, but is a new cancer (secondary malignancy) altogether.

The latest I've read suggest that the incidence can be viewed as an increasing probability as the disease progresses over time. The rate estimated is about one percent per year in unmutated patients. That means if one lives for 10 years with CLL, there is a 10 % change the clone will transform into Richter's.

All of the amazing news coming in CLL is wonderful, but there is little progress in treating Richter's. I'm going to concentrate my charitable giving on Richter's, as the options are poor, and I'm at risk.

'Here Be Dragons'

The 2007 ASH (American Society of Hematology) meeting is currently underway in Atlanta, Georgia. I am all to well aware of this since my researcher-doctor-CLL expert is in the Peach State, I suppose delivering what few items he has learned this year to the rank-and-file hematologist.

CLL remains a terrible mystery and so little is known about the disease.

If there were a map of the CLL terrain, much would be labeled, 'Here Be dragons'.

My RDC (see above) has told me, as I get sicker and sicker, that 'We have to do a better job'. Well, yeah. Since I am most likely doomed by CLL, ya think?

I told him not to be too hard on himself, since there is much blame to spread around, and, well, you know, lifting the curtain on God's mysteries is not easy work.