{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:06:59Z","timestamp":1791245219962,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"Summary<\/jats:title>\n \n Chronic lymphocytic leukaemia (CLL) primarily affects elderly patients with comorbidities, yet real\u2010world data on acalabrutinib, a second\u2010generation Bruton's Tyrosine Kinase (BTK) inhibitor, remain limited outside clinical trials, particularly in Italy. This retrospective multicentre study evaluated acalabrutinib monotherapy across 10 Italian haematology centres (2021\u20132025), including 155 adults with CLL\/small lymphocytic lymphoma (SLL) (median age 74\u2009years, 44.5% \u226575\u2009years, 35.5% relapsed\/refractory, 59.4% cardiovascular comorbidities, 24.5% del17p\/TP53). Primary end\u2010point was time\u2010to\u2010discontinuation (TTD \u226528\u2009days interruption\/progression\/death); secondary included response rates (based on International Workshop on Chronic Lymphocytic Leukemia criteria), haematological recovery, overall survival (OS) and safety. Median TTD was not reached (16\u2009months follow\u2010up), overall response rate 84.5% (32.9% clinical complete remission, reinforced by bone marrow evaluation in four cases), OS median not reached (78.7% alive), reporting rapid haematological recovery occurred (at 6\u2009months haemoglobin 11.1\u201312.6\u2009g\/dL, platelets 146\u2013160\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L, lymphocytes 57.5\u201312.3\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L;\n p<\/jats:italic>\n \u2009<\u20090.001), uniform across subgroups (no TTD differences by age\/line\/cardiovascular comorbidities\/biology;\n p<\/jats:italic>\n \u2009>\u20090.05), without reduction of neutrophils (\n p<\/jats:italic>\n \u2009=\u20090.48). Discontinuation was 20% (primarily due to adverse events), with low cardiovascular toxicity (one grade 3 atrial fibrillation). This study confirms acalabrutinib's durable effectiveness and tolerability in unselected real\u2010world CLL, above in patients with prior cardiovascular comorbidities, confirming clinical trial results also in frail elderly\/high\u2010risk patients, supporting its broad adoption in routine care.\n <\/jats:p>","DOI":"10.1111\/bjh.70638","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:51:44Z","timestamp":1783054304000},"page":"1010-1019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real\u2010world effectiveness and safety of acalabrutinib in chronic lymphocytic leukaemia: Multicentre experience"],"prefix":"10.1111","volume":"209","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9510-4755","authenticated-orcid":false,"given":"Andrea","family":"Duminuco","sequence":"first","affiliation":[{"name":"Dipartimento di Scienze Mediche Chirurgiche e Tecnologie Avanzate \u2018G.F. Ingrassia\u2019 University of Catania Catania Italy"},{"name":"Hematology Unit With BMT AOU Policlinico \u2018G.Rodolico\u2010San Marco\u2019 Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Leotta","sequence":"additional","affiliation":[{"name":"Hematology Unit With BMT AOU Policlinico \u2018G.Rodolico\u2010San Marco\u2019 Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Allegra","sequence":"additional","affiliation":[{"name":"Hematology Section A.O.U. Policlinico \u2018G. 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