Zanubrutinib as upfront treatment in de-novo B-cell prolymphocytic leukemia: the case of two elderlies

B-cell prolymphocytic leukemia (B-PLL) is a rare lymphoproliferative disorder characterized by splenomegaly, lymphocytosis, and poor prognosis. Treatment options are limited, with modest responses to chemo-immunotherapy. We present two elderly patients with B-PLL treated with Zanubrutinib, a secondgeneration BTK inhibitor, achieving good disease response and tolerance. Both had TP53 deletion/mutations and a high-risk complex karyotype. hematologic parameters and spleen size. Given the rarity promising drug in this rare orphan drug disease.