A Rare Case of B-cell Prolymphocytic Leukemia: The First Documented Diagnosis in Georgia With a Comprehensive Literature Review.

B-cell prolymphocytic leukemia (B-PLL) is a rare and aggressive malignancy of mature B-cells associated with poor prognosis, limited treatment options, and a median survival of approximately three years. We report the first documented case of B-PLL in the country of Georgia, involving a 64-year-old male presenting with fever, night sweats, weight loss, and generalized lymphadenopathy. Initial investigations revealed significant lymphocytosis and a predominance of prolymphocytes on the peripheral smear. The diagnosis was confirmed through bone marrow aspirate analysis and flow cytometry, demonstrating clonal B-cell proliferation with a characteristic immunophenotype. The patient was treated with a rituximab-bendamustine (R-B) regimen, achieving complete remission with no detectable minimal residual disease. Remarkably, he remains in clinical remission two years post-diagnosis, underscoring the potential of early and precise diagnosis combined with individualized therapeutic strategies in managing B-PLL. This case highlights the importance of further research to optimize treatment approaches and improve outcomes in this rare and challenging disease.