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Transformed DLBCL commonly add CDKN2A deletions and MYC translocations or amplifications on top of the genomic alterations currently present in the first CLL, but absence the frequent mutations noticed in primary DLBCL indicating that they may perhaps correspond to a unique biological class.80 Richter transformation also occurs in clients taken care of with BTK inhibitors. These tumors don't usually get BTK or PLCG2 mutations but, if these were existing in the initial CLL, subclones might arise with supplemental unbiased mutations.89,90
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