Evidence map›Paper›PMID 42630810›Full record

ArticleCase reports in hematology2026

Prolymphocytic Progression in Chronic Lymphocytic Leukemia Without Richter Transformation: An Eighteen-Year Clinical-Diagnostic Correlation.

Harini Venkatraman Ravisankar, Kavita Umrau, Liang Cheng, Magdalena Czader, Rohit Gulati

Abstract read
In one paragraph

Article in Case reports in hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Harini Venkatraman RavisankarDepartment of Pathology and Laboratory Medicine, Indiana University School of Medicine, 350 W 11th Street, Indianapolis Indiana, 46202, USA, indiana.edu.ORCID https://orcid.org/0009-0009-8595-6733
Kavita UmrauDepartment of Pathology and Laboratory Medicine, Indiana University School of Medicine, 350 W 11th Street, Indianapolis Indiana, 46202, USA, indiana.edu.ORCID https://orcid.org/0009-0007-7790-6598
Liang ChengDepartment of Pathology and Laboratory Medicine, Brown University, Providence 02912, Rhode Island, USA, brown.edu.ORCID https://orcid.org/0009-0004-2260-6254
Magdalena CzaderDepartment of Pathology and Laboratory Medicine, Indiana University School of Medicine, 350 W 11th Street, Indianapolis Indiana, 46202, USA, indiana.edu.ORCID https://orcid.org/0009-0005-9424-2709
Rohit GulatiDepartment of Pathology and Laboratory Medicine, Indiana University School of Medicine, 350 W 11th Stree Room 5048, Indianapolis Indiana, 46202, USA, indiana.edu.ORCID https://orcid.org/0000-0002-7113-1679

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic lymphocytic leukemia (CLL) is an indolent neoplasm of small, mature B lymphocytes characterized by clumped chromatin and scant cytoplasm. A minor subset of neoplastic cells may exhibit prolymphocytic morphology, with prominent nucleoli and moderate cytoplasm. An increased proportion of prolymphocytes in peripheral blood often correlates with an accelerated or aggressive disease course, distinct from Richter transformation (RT), which more commonly manifests as diffuse large B-cell lymphoma and requires intensified therapy. We report an 18-year clinical course of CLL in a 57-year-old man that evolved to prolymphocytic progression without transformation to large-cell lymphoma. Serial morphological assessments revealed a steady increase in prolymphocytes compatible with prolymphocytic progression in CLL and excluded RT. At the final assessment, 70%-80% of circulating lymphocytes exhibited prolymphocytic morphology, fulfilling criteria for prolymphocytic progression and reclassification as accelerated CLL. Accompanied immunophenotypic and IgH gene rearrangement findings confirmed CLL clonality. This case underscores the diagnostic and prognostic importance of recognizing prolymphocytic progression and integrating morphology with immunophenotypic and molecular data in the longitudinal management of CLL.

Indexed as

accelerated CLLB-prolymphocytic leukemiachronic lymphocytic leukemiadiffuse large B-cell lymphomagenetics of CLLprolymphocyteprolymphocytes in CLLprominent proliferation centersRichter transformationsmall lymphocytic lymphoma

Identifiers

PMID42630810
PMCPMC13495556

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.