A, Study schema. Ibrutinib was given at 420 mg orally once daily. Fludarabine was given at 25 mg/m2/day intravenously on day 1–5 of cycle three and four. B, Response by iwCLL criteria. C, Progression-free and overall survival by Kaplan–Meier estimates. D, Absolute number of T cells during therapy. Black solid lines indicate the median of the group. E, Absolute numbers of follicular helper T cells (TFH) and FH regulatory T cells (Treg). Statistical significance by Wilcoxon matched-pairs signed-rank test is indicated. Abbreviations: CR, complete response; CR-i, complete response with incomplete hematologic recovery; n.s., not significant; PD, progressive disease; PR, partial response; PRL, partial response with persistent lymphocytosis; SD, stable disease