Patients with chronic lymphocytic leukemia (CLL) who progress to Richter transformation (RT) have a poor prognosis. Multi-agent chemotherapy regimens do not have good response rates. There are few case reports on the use of ibrutinib in RT. Here, we present a patient who was heavily pretreated for CLL, including allogeneic stem cell transplant, and progressed to RT. She had a mixed response to multi-agent chemotherapy and was started on ibrutinib. She had a complete response for 16 months on single-agent ibrutinib with minimal toxicity.

correction of our HCT-CI workflow initiates a precise process for scoring and reporting of comorbidities. We expect our novel quality improvement process to provide a superlative data management tool for future quality improvement initiatives in service of our patients, as we have recently demonstrated in the management of acute graft vs. host disease (Ravulapati et al, 2016).

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