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Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Therapeutic strategies for patients affected by Chronic Lymphocytic Leukemia (CLL) have undergone significant changes over the last decade, shifting from chemoimmunotherapy to targeted therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, single-center, real-word study aims to identify candidate prognostic markers in 230 consecutive CLL patients treated with standard chemoimmunotherapies or targeted agents from July 2011 to June 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients receiving targeted therapy were more likely to have mutated <jats:italic>IGHV<\/jats:italic>, while those with a CD38<jats:sup>+<\/jats:sup>CD49d<jats:sup>+<\/jats:sup> CLL immunophenotype showed an increased risk of refractoriness and disease recurrence, as demonstrated by multivariate analysis. Conversely, CLL patients with a CD38<jats:sup>-<\/jats:sup>CD49d<jats:sup>-<\/jats:sup> phenotype received great benefits when treated with targeted agents, whereas advanced age was a negative risk factor for patients treated with standard chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In conclusion, CD38 expression emerges as a key prognostic marker in CLL, reinforcing the need to integrate clinical, biological, phenotypic, and molecular factors into treatment decision-making and both standard chemotherapy and targeted regimens remain effective in real-life settings.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1569707","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T05:26:34Z","timestamp":1746681994000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["CD38 prognostic role in chronic lymphocytic leukemia patients treated with 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