Interestingly, the CLL-derived exosomal Y RNA, hY4, promotes monocytes in CLL patients to adopt an immunosuppressive phenotype, including promoting the expression of PD-L1, and showed that hY4 promotes exosome-dependent skewing of monocytes in a TLR7-dependent manner. This evidence concerns the gene RNY4 and B-cell chronic lymphocytic leukemia.