The therapeutic armamentarium will likely continue to expand with the emergence of T-cell directing therapies, chimeric antigen receptor T-cell (CAR-T) therapy [4–8], bispecific antibodies (bsAb) [9], and BTK degrader molecules [10, 11] which demonstrate promise in early phase studies treating RR CLL. This evidence concerns the gene BTK and B-cell chronic lymphocytic leukemia.