Treating young patients with chronic lymphocytic leukemia (CLL) poses a unique set of challenges because treatment has to be effective for many years, and even decades. Matthew Davids, MD, MSc, of the Dana-Farber Cancer Institute, Boston, MA spoke to us about these challenges at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden. Here, he discusses the risk of resistance mutations and toxicity when young patients are given long-term monotherapies, and points to combination therapies incorporating novel agents as the way forward in this patient group.