This finding is consistent with the study of Joshi et al. [38] showing that the level of CTLA-4 gene expression in CLL cells predicts clinical outcome of CLL patients; lower expression of CTLA-4 is associated with significantly shorter time to treatment and poor prognosis compared with high CTLA-4 expression associated with good clinical outcome. The gene discussed is CTLA4; the disease is B-cell chronic lymphocytic leukemia.