{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:24:04Z","timestamp":1786962244337,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":228,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007514","name":"Universit\u00e0 di Pisa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007514","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Hematology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Central nervous system (CNS) and extralymphatic involvement in chronic lymphocytic leukemia (CLL) is rare and associated with poor prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Description<\/jats:title>\n                    <jats:p>We report the case of a 45\u2010year\u2010old woman with refractory CLL who developed CNS and extralymphatic lesions after three prior lines of therapy, including rituximab\u2013bendamustine, rituximab\u2013idelalisib, and rituximab\u2013venetoclax. Third\u2010line treatment with rituximab\u2013venetoclax led to partial remission (PR), followed by a 2\u2010month treatment\u2010free interval before the emergence of a new lesion. Treatment with zanubrutinib, a second\u2010generation Bruton\u2019s tyrosine kinase inhibitor (BTKi), was initiated, resulting in significant clinical improvement and near\u2010complete resolution of lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Zanubrutinib\u2019s enhanced blood\u2013brain barrier (BBB) penetration and favorable safety profile make it a promising option for CNS\u2013CLL and also for other extralymphatic lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case underscores the potential of zanubrutinib in addressing challenging CLL presentations.<\/jats:p>\n                  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