Particular attention was given to the interaction between CH and contemporary therapeutic strategies, including Bruton tyrosine kinase (BTK) inhibitors and BCL2 inhibitors, and their potential influence on long-term outcomes.<h4>Results</h4>Available evidence indicates that CH is relatively frequent in patients with CLL and may contribute to disease biology through mechanisms involving genomic instability, chronic inflammation and immune system alterations. This evidence concerns the gene BTK and B-cell chronic lymphocytic leukemia.