Introduction: Over a decade, there was a significant change in the management of patients with Chronic Lymphocytic Leukemia (CLL) form the diagnostic & therapeutic prospective. The diagnostic approaches moved from flow cytometry based diagnosis toward molecular cytogenetic with molecular profiling and immunoglobulin heavy chain mutation analysis that defined the disease and treatment options that can be offered to CLL patients. At the same time, treatment choices moved from chemotherapy and chemo-immunotherapy (CIT) based therapies to B Cell Receptor (BCR) molecular targeted therapy with the main use of Bruton Tyrosine Kinase Inhibitors (BTKi); namely Ibrutinib & Acalabrutinib. Method: Retrospective analysis of treatment outcome and complications of patients with CLL diagnosed over a decade. IRB approval was obtained and there is no conflict of interest. Results: over a decade (2014 to 2024) 41 patients were identified with CLL, 16 women and 25 men, with a median age of 60-70. Of these 41 patients, 13 died (31%) 4 due Richter's Transformation (RT) (31% of died patient). 3 out of these 4 cases (75%) had RT post CIT and only 1 patient was on BTKi (Ibrutinib). 2 additional cases had RT while on observational stage, one had chemo (ABVD for Hodgkin's Lymphoma), while the other had Venetoclax plus R-CHOP followed by Allogeneic BMT and now he is on Ibrutinib for GvHD & CLL relapse prevention. Of these 41 patients 20 were treated with BTKi of Ibrutinib, but 8 patients (40%) were switched to Acalabrutinib due to different adverse events. Conclusions: CLL management changed dramatically

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No relevant conflicts of interest to declare.

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2024
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