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Although the results appeared to confirm the clonal selection hypothesis, Nossal and Lederberg were unable to 'exclude a residual production of other antibodies at lower rates' and called for further studies into the issue (Nossal, Lederberg)

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In the Phase 3 GAIA (CLL13) clinical trial,58 patients with CLL who were fit and had no TP53 gene abnormalities were randomized in a 1:1:1 ratio to receive six cycles of chemotherapy: one to six cycles of chemoimmunotherapy (fludarabine-cyclophosphamide-rituximab or bendamustine-rituximab) or 12 cycles of venetoclax-rituximab, venetoclax-obinutuzumab or venetoclax-obinutuzumab-ibrutinib