Do complex cytogenetics have any therapeutic or prognostic relevance in CLL?  

62 year old patient with TP53 mutation by NGS, treated 12 years ago with FCR, then at first relapse 2 years ago started ibrutinib.  Bone marrow biopsy performed upon progression while still on ibrutinib demonstrated > 9 chromosomal abnormalities on karyotype, but no dysplatic morphology to suggest MDS.