[CAR-T cell therapy bridging to allogeneic hematopoietic stem cell transplantation for diffuse large B-cell Richter syndrome: a case report and literature review].

This study aimed to explore the application of CAR-T cell therapy bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with diffuse large B-cell Richter syndrome, and to review recent advances in the diagnosis, pathogenesis, and treatment of this disease. We retrospectively analyzed the diagnosis and treatment course of one patient diagnosed with Richter syndrome at Binzhou Medical University Hospital and reviewed relevant literature. The patient was a 49-year-old female with a history of chronic lymphocytic leukemia (CLL) for over two years, who presented with a progressively enlarging right neck mass, and was ultimately diagnosed with transformation of CLL into diffuse large B-cell lymphoma (DLBCL) , i.e., Richter syndrome. The patient initially achieved a partial response after three cycles of R-DA-EPOCH combined with zanubrutinib therapy. Following disease progression, the treatment regimen was adjusted to a combination of PD-1 monoclonal antibody, CD20 monoclonal antibody, XPO1 inhibitor, and zanubrutinib for one cycle. This was followed by infusion of autologous anti-CD19 CAR-T cells and subsequent bridging to allo-HSCT. Assessments at 3 and 8 months post-transplantation both demonstrated disease complete remission.