Richter’s Transformation as leptomeningeal infiltration in a Chronic Lymphocytic Leukemia patient receiving Venetoclax. Could blood-brain barrier be a disease “sanctuary” during Venetoclax treatment?

We present a unique Richter’s transformation case in CNS with identical to CLL clonal origin in a patient treated with Venetoclax. With our case we make implications on whether Venetoclax penetrates the blood-brain barrier and we address the debating issue of the appropriate Venetoclax dose in case of drug-drug interactions.