Richter's transformation: status quo and quo vadis

Despite remarkable advancements in the last decade for individuals with chronic lymphocytic leukemia (CLL), the prognosis for those with Richter transformation (RT) remains poor, unfavorable and still challenging. Multiagent chemoimmunotherapy agents which are usually anthracycline based have been frequently employed; however, the outcomes are significantly inferior compared to those seen with identical regimens in de novo diffuse large B-cell lymphoma. Despite the emergence of numerous novel therapeutic agents in the last few years and yet still more to come, almost all studies outcomes are still not satisfactory to control this aggressively transformed CLL state.