Nevertheless, more studies should be conducted on CLL metabolic changes between cultured and freshly isolated lymphocytes to understand through which mechanism Hif-1a is stabilized since hydroxylase activity could be inhibited not only by low concentrations of O2 but as well by high concentrations of tricarboxylic acid cycle intermediates (isocitrate, oxaloacetate, succinate, or fumarate), or chelators of Fe(II) changes [32-34]. Here, HIF1A is linked to B-cell chronic lymphocytic leukemia.