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Triple therapy for CLL, AVO, is highly active and has very high MRD-negative rates compared to other studies using Ven+Obi or BTKi therapy alone. The battle between indefinite BTKi therapy vs more intense combination therapy will continue as we don’t know if one paradigm is better from a bigger picture.

This study was done with and without obinutuzumab, both arms beat obinutuzumab and chlorambucil. There were more deaths in the obinutuzumab arm even though it was superior because of COVID, so it is immunosuppressive.

Ibrutinib delays disease progression for asymptomatic patients but has no overall survival (OS) benefit; hence, still watch and wait in those patients.

A small number of patients in this study, but it is an interesting test to predict who can be off therapy in CML. Patients who are high risk probably should to be taken off therapy, but this gives us something to build on.

While use of Hydroxyurea for CMML may not be common practice, it is an option.