Similar information emerged from the analysis of the Gruppo Italiano Malattie Ematologiche dell’Adulto LLC0405 protocol that used the association of fludarabine and alemtuzumab in high-risk CLL (57), while NOTCH1 mutation was unexpectedly identified as an independent favorable marker for PFS in fludarabine-refractory patients treated with alemtuzumab in the CLL2H trial of the German CLL Study Group (77). This evidence concerns the gene NOTCH1 and B-cell chronic lymphocytic leukemia.