Unexpected Durable Treatment-Free Disease Control After Acalabrutinib Cessation: A Case Report

We describe a man diagnosed with chronic lymphocytic leukaemia (CLL) at the age of 80 who achieved sustained disease control following discontinuation of acalabrutinib. Initially managed with a watch-and-wait approach, treatment was initiated after evidence of disease progression. Acalabrutinib was commenced but subsequently stopped due to significant adverse effects, including severe anaemia requiring transfusion support. Unexpectedly, serial blood monitoring after cessation demonstrated persistent stability of lymphocyte counts without further CLL-directed therapy. To our knowledge, this represents a rare example of durable treatment‑free disease control following acalabrutinib discontinuation, highlighting the need for further research into predictors of sustained remission after targeted therapy withdrawal.