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We evaluated therapeutic patterns and outcomes [including overall survival (OS), time to next treatment or death (TTNT-D) and overall response rate (ORR)] and documented the incidence of other malignancies of patients who initiated first-line treatment between 2010 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a panhellenic multicenter retrospective study of patients diagnosed with CLL between 2010 and 2020 from 8 centers in Greece.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 1318 patients were included in the study. Fludarabine, cyclophosphamide and rituximab (FCR) was the most common first-line regimen (21.6%), followed by chlorambucil plus rituximab (16.3%) and ibrutinib-based therapies (14%). In the R\/R setting, ibrutinib and venetoclax-based treatments, became the predominant therapeutic choices after 2014, replacing chemoimmunotherapy. Shifts in treatment patterns before and after 2016 reflected the incorporation of targeted agents into routine clinical practice, with a marked decline in FCR use and increased adoption of targeted therapies. Median OS was 162\u00a0months from diagnosis and 105.2\u00a0months (95% CI: 90.3\u2013116.3) from first treatment. In patients receiving ibrutinib as first-line therapy, mOS was not reached, and median TTNT-D was 67.3\u00a0months.<\/jats:p>\n                    <jats:p>Overall, 18 (1.4%) cases developed a second hematological malignancy and 59 (4.5%) were diagnosed with a solid tumor. The most common hematological malignancy was myelodysplastic neoplasms and the most common solid tumors included lung, skin, breast, colon and prostate cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings suggest a gradual shift in CLL treatment patterns in Greece, with targeted agents increasingly replacing traditional chemoimmunotherapy in recent years and showing favorable survival outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00277-026-07161-3","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T03:33:59Z","timestamp":1783049639000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world treatment patterns and outcomes in chronic lymphocytic leukemia: a multicenter retrospective study in 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Kostas Stamatopoulos received research support from AbbVie, AstraZeneca, Janssen, Novartis, and Roche; honoraria from AbbVie, AstraZeneca, Bristol Myers Squibb, Janssen and Lilly. Thomas Chatzikonstantinou received honoraria from AbbVie, AstraZeneca, and BeOne. No other potential competing interests were reported.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"The study supporters did not have access to the data and were not involved in the study design, collection, analysis, or interpretation of the data, the writing of the article, and the decision to submit it for publication.","order":3,"name":"Ethics","label":"Disclaimer","group":{"name":"EthicsHeading","label":"Ethics"}}],"article-number":"426"}}