Richter syndrome (RS) is a rare transformation of relatively.low-grade malignant chronic lymphocytic leukemia (CLL) tomore aggressive lymphoma.The most common form of RS is transformation to diffuse large B-cell lymphoma (> 95%) and much less frequently (< 1%) to Hodgkin lymphoma (HL), plasma blast lymphoma, or other rare lymphomas.[1] Once transformed, the prognosis is extremely poor with a median survival of five to fourteen months.[2] There are presently no standard salvage approaches for RS.