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Molecular and cytogenetic profiling was performed using MLPA for copy number variations and targeted next-generation sequencing for mutation detection, following DNA extraction from peripheral blood and standardized bioinformatic analysis pipelines. The patient exhibited concomitant del(13q14) and del(17p13), alongside two pathogenic TP53 mutations, indicating functional inactivation of p53 and a high-risk genomic profile; despite this, treatment with a Bruton\u2019s tyrosine kinase inhibitor resulted in significant hematological improvement within six months. These findings highlight that adverse TP53 alterations override favorable cytogenetic markers and emphasize the necessity of comprehensive genomic testing to guide prognosis and personalized therapy in CLL.<\/jats:p>","DOI":"10.3390\/ijms27135843","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:55:11Z","timestamp":1782780911000},"page":"5843","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Complex TP53 Alterations with del(17p) and del(13q) in Chronic Lymphocytic Leukemia: Clinical Implications from a Case-Based Review"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9256-4051","authenticated-orcid":false,"given":"Beata","family":"Balla","sequence":"first","affiliation":[{"name":"Department of Medical Genetics, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"Genetics Laboratory, Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"Medical Genetics Laboratory, Emergency County Hospital of T\u00e2rgu Mure\u0219, 540136 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Crauciuc","sequence":"additional","affiliation":[{"name":"Genetics Laboratory, Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erzsebet","family":"Lazar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3235-524X","authenticated-orcid":false,"given":"Claudia","family":"B\u0103nescu","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"Genetics Laboratory, Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"},{"name":"Medical Genetics Laboratory, Emergency County Hospital of T\u00e2rgu Mure\u0219, 540136 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.critrevonc.2016.06.003","article-title":"Chronic Lymphocytic Leukaemia","volume":"104","author":"Ferreri","year":"2016","journal-title":"Crit. 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