It has been shown previously that mutations in individual ribosomal proteins, for example, RPL38, although not affecting global protein synthesis rates affect transcript-specific translational control.55 Therefore, we speculate that in CLL the decrease in DKC1 expression, leading to reduced synthesis of subsets of ribosomal proteins selectively alters the translatome and that this is in turn is associated with tumorigenesis. This evidence concerns the gene RPL38 and B-cell chronic lymphocytic leukemia.