Prior to the era of Bruton tyrosine kinase inhibitors (BTKi), traditional chemotherapy regimens such as R-CHOP and R-EPOCH yielded unsatisfactory outcomes for both relapsed/refractory and transformed follicular lymphoma [9, 10, 28–34].The emergence of novel targeted agents including BTKi and Bcl-2 inhibitor venetoclax brought about novel strategies has introduced new treatment strategies for this patient population; however, ORR and CR rates achieved with single-agent therapy were only approximately 40–75% and 10–25%, respectively [11, 35–39]. This evidence concerns the gene IBTK and follicular lymphoma.