The identification of this B-CLL subgroup is somewhat surprising, since these cases represent a poor prognosis subset essentially lacking CD38 expression and without an excess of cases with low IgVH percent mutations and/or lack of antigen-driven selection [28,48,49]; this group might, therefore, represent a separate entity, allegedly characterized by a distinct pathway of oncogenesis [6,57])), that deserves to be further investigated. This evidence concerns the gene CD38 and B-cell chronic lymphocytic leukemia.