Glucocorticosteroids impose metabolic stress on B-CLL cells by altering metabolic gene expression and activity in CLL cells, prevention of tumor cells from accessing bioenergetic programs required to respond to membrane damage, and increasing the dependence of CLL cells on fatty acid oxidation by altering the expression of PPARa and PDK4 [26]. The gene discussed is PDK4; the disease is B-cell chronic lymphocytic leukemia.