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The prognosis and treatment of chronic lymphocytic leukemia (CLL) have improved significantly over the last years; however, CLL is still an incurable disease and infections are the major cause of morbidity and mortality, contributing to 25-50% of deaths. 1 Susceptibility to infections in CLL patients can be related to immunological defects associated with the disease (including hypogammaglobulinemia, T-cell, natural killercell and innate immunity dysfunctions) 2 and secondary to chemo-immunotherapy. Hypogammaglobulinemia and T-cell defects are quite common in these patients and become more pronounced with advanced-stage disease. 2 Interestingly, it has been described that even patients with monoclonal B-cell lymphocytosis have a higher risk of serious infection than do the general population. 3 Strategies to prevent bacterial infections in patients with symptomatic hypogammaglobulinemia include …