Chronic lymphocytic leukemia is an incurable disease, but as a chronic malignant disease common in the elderly, its natural course can be long, a few patients can be asymptomatic for more than a decade and do not need treatment, some patients have obvious symptoms at the beginning of the disease and need immediate treatment, and may die soon from the disease itself. As for when to start treatment is affected by many factors, such as lymphocyte multiplication time, clinical stage, clinical symptoms, etc. The most important is the immunophenotype of tumor cells, gene mutation status, chromosomal alterations, etc. Some patients may have no symptoms, but if there are high-risk factors such as chromosomal alterations with poor prognosis, it is highly suggestive that the patient will progress faster and needs active treatment, although temporarily asymptomatic, some Asymptomatic patients may even require hematopoietic stem cell transplantation. Therefore, cytogenetic (chromosomal) alterations and other biological changes (e.g., mutation status) in chronic lymphocytic leukemia can be a good guide for patient treatment and prognosis. At present, there are not many units in China that can carry out the full set of tests, but our hospital has carried out most of the relevant tests that have been carried out abroad, and some of them are free of charge because they have not been included in the routine testing program for the time being. If you can adhere to our treatment recommendations and choose a treatment modality (such as waiting for observation or active treatment), you can perform the relevant tests at our hospital.