In the case of the index patient, the combination of tiredness, fatigue, exhaustion, pronounced leukocytosis, repeatedly elevated CRP, and slightly elevated GOT, GPT, and lactate dehydrogenase (LDH), along with findings of increased lymphocytes in the bone biopsy and splenomegaly, pointed toward the relapse of CLL. This evidence concerns the gene GPT and Increased total leukocyte count.