These are assisted by several clonal factors that potentiate migratory responses favoring clinical lymphadenopathy and poor outcome, including the presence of certain adverse prognostic factors such as CD38, ZAP70, CD49d, trisomy 12, NOTCH1 mutations, or un-mutated IGHV (42, 48, 49, 51, 53, 58–61, 64, 65, 75, 87, 108–111). This evidence concerns the gene CD38 and Lymphadenopathy.