Chronic lymphocytic leukemia (CLL) treatment has advanced from chemotherapy in the 1950s to monoclonal antibodies, BTK inhibitors like ibrutinib, and BCL-2 inhibitors such as venetoclax. Survival improved from 65% in 1975 to over 87% in 2021, though CLL remains incurable. Current NCCN guidelines recommend BTKis or venetoclax combinations, with zanubrutinib now preferred for many patients. Relapsed cases often rely on clinical trials, CAR-T, or novel BTKis. The U.S. dominates the CLL market, led by AbbVie, Janssen, Genentech, and AstraZeneca, with aging populations driving future demand for innovative therapies.

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