We present the case of a 71-year-old woman diagnosed with chronic lymphocytic leukemia who received multiple chemotherapeutic lines and evolved to acute lymphoblastic leukemia. The patient was Rai stage 0 at the time of the diagnosis and was monitored for almost 9 years. After that, the disease progressed and the patient began chemotherapy (fludarabine/cyclophosphamide combination), obtained complete remission and relapsed one year later after finishing treatment. She received multiple therapeutic regimens, accompanied by multiple infectious complications. After 8 years of evolution since she started chemotherapy, bone marrow aspirate and immunophenotyping revealed acute lymphoblastic leukemia. The occurrence of acute leukemia in CLL is rare and may arise from the same clone; however, most cases appear after patients have received chemotherapy, suggesting that they are therapy-related.
; 88(1-2): 82-86. Gisselsson D, Andreasson P, Meis-Kindblom JM, Kindblom LG, Mertens F, Mandahl N. Amplification of 12q13 and 12q15 sequences in a sclerosing epitheloid fibrosarcoma. Cancer Genet Cytogenet 1998; 107(2): 102-106. Stock AD, Dennis TR. A translocation breakpoint at chromosome band 12q13 associated with B-cell chronic lymphocytic leukemia. Cancer Genet Cytogenet 1999; 111(2): 166-168. Santulli B, Kazmierczak B, Napolitano R, Caliendo I, Chiappetta G, Rippe V, Bullerdiek J, Fusco A. A 12q13 translocation involving the HMGI-C gene in richter
9 16 Tabateau S, Garidi R, Fernandes J, et al. Fludarabine (FAMP) and risk of occurrence of Richter’s syndrome among B-CLL. Blood 2000;96:295. Tabateau S Garidi R Fernandes J et al Fludarabine (FAMP) and risk of occurrence of Richter’s syndrome among B-CLL Blood 2000 96 295 17 Wang Y, Tschautscher M, Rabe K, et al. Clinical characteristics and outcomes of Richtertransformation: experience of 204 patients from a single center. Haematol 2019.224121 [Epub ahead of print]. Wang Y Tschautscher M Rabe K et al Clinical characteristics and outcomes of Richter