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Richter transformation continues to be an ominous event for patients with CLL, particularly when it really is clonally connected to the original CLL, mainly because Not one of the lately accredited novel agents is really powerful. Without a doubt, disorder transformation is a comparatively common explanation for failure to benefit from these medicines.90,128,129 Histological affirmation is always suggested because it can guidebook prognosis (i.e., Hodgkin lymphoma and clonally unrelated tumors have far more favorable prognosis).
Environmental or self-antigens and homotypic interactions cause BCR and Toll-like receptor (TLR) signaling, amplifying the reaction of CLL cells to other signals from your microenvironment and increasing the activation of anti-apoptotic and proliferation pathways.
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