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This increase allows for greater microbial translocation to the liver, exposing hepatic immune cells to foreign antigens and subsequently triggering protective immune responses [58]

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In a recent analysis from the Brazilian Group of CLL, the most common presentations of CNS involvement were highlighted and relatively good outcomes were found, particularly with ibrutinib-based regimens.5,6 Given its potential impact, any neurological symptoms in CLL patients should prompt a thorough CNS evaluation to guide timely intervention