Richter Transformation: Clinical Manifestations, Evaluation, and Management

Richter transformation is a devastating and rare but not uncommon development of an aggressive B-cell lymphoma in patients with chronic lymphocytic leukemia or small lymphocytic lymphoma. Prognosis is dismal, with survival generally in the realm of months to a couple of years. Many patients progress quickly after traditional first-line immunochemotherapy. Nonetheless, novel therapies are on the horizon. It is important that the advanced practitioner have awareness and knowledge of this condition in order to furnish a crucial timely diagnosis and to provide appropriate treatment.