This article, published in Hematological Oncology, explores the role of karyotype in predicting the need for therapy in chronic lymphocytic leukemia (CLL) with 13q deletion. The study analyzed the karyotype of 106 CLL cases with isolated 13q deletion and found that the presence of additional chromosomal abnormalities increased the risk of requiring treatment. The study also confirmed the predictive role of immunoglobulin heavy variable (IGHV) gene mutation status in therapy requirement. The authors propose a classification system based on both IGHV status and karyotype to better predict the need for therapy in low-risk CLL patients.