Maria D'Amato, Claudia Baratè, Giulia Cervetti, Mariacostanza Caparello, Valerio Ortenzi, Antonio Giuseppe Naccarato, Edoardo Benedetti, Sara Galimberti
{"title":"Zanubrutinib, a New Bullet Against Chronic Lymphocytic Leukemia Even When Localized in Central Nervous System.","authors":"Maria D'Amato, Claudia Baratè, Giulia Cervetti, Mariacostanza Caparello, Valerio Ortenzi, Antonio Giuseppe Naccarato, Edoardo Benedetti, Sara Galimberti","doi":"10.1155/crh/4126471","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Central nervous system (CNS) and extralymphatic involvement in chronic lymphocytic leukemia (CLL) is rare and associated with poor prognosis.</p><p><strong>Case description: </strong>We report the case of a 45-year-old woman with refractory CLL who developed CNS and extralymphatic lesions after three prior lines of therapy, including rituximab-bendamustine, rituximab-idelalisib, and rituximab-venetoclax. Third-line treatment with rituximab-venetoclax led to partial remission (PR), followed by a 2-month treatment-free interval before the emergence of a new lesion. Treatment with zanubrutinib, a second-generation Bruton's tyrosine kinase inhibitor (BTKi), was initiated, resulting in significant clinical improvement and near-complete resolution of lesions.</p><p><strong>Discussion: </strong>Zanubrutinib's enhanced blood-brain barrier (BBB) penetration and favorable safety profile make it a promising option for CNS-CLL and also for other extralymphatic lesions.</p><p><strong>Conclusion: </strong>This case underscores the potential of zanubrutinib in addressing challenging CLL presentations.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"4126471"},"PeriodicalIF":0.7000,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479106/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Hematology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/crh/4126471","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Central nervous system (CNS) and extralymphatic involvement in chronic lymphocytic leukemia (CLL) is rare and associated with poor prognosis.
Case description: We report the case of a 45-year-old woman with refractory CLL who developed CNS and extralymphatic lesions after three prior lines of therapy, including rituximab-bendamustine, rituximab-idelalisib, and rituximab-venetoclax. Third-line treatment with rituximab-venetoclax led to partial remission (PR), followed by a 2-month treatment-free interval before the emergence of a new lesion. Treatment with zanubrutinib, a second-generation Bruton's tyrosine kinase inhibitor (BTKi), was initiated, resulting in significant clinical improvement and near-complete resolution of lesions.
Discussion: Zanubrutinib's enhanced blood-brain barrier (BBB) penetration and favorable safety profile make it a promising option for CNS-CLL and also for other extralymphatic lesions.
Conclusion: This case underscores the potential of zanubrutinib in addressing challenging CLL presentations.