Chronic lymphocytic leukemia (CLL) is usually fairly non-aggressive; however, there remain certain patients who have a rapidly progressing disease and require effective treatment. Currently, chemotherapy is the standard treatment for aggressive CLL, but there has been a recent influx of highly effective novel agents with the potential to replace chemotherapy, as Guy Pratt MD, FRCP, FRCPath, of the University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK, explains at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden. Dr Pratt gives an overview of these novel therapies: ibrutinib, venetoclax and idelalisib, and discusses the promising results from trials combining these agents.