The pathophysiological role of these exosomal miRNAs include the promotion of CLL cell survival by (a) altering transcription in the CLL cell by removing tumor-suppressor miRNAs, (b) altering functions of cells of the tumor microenvironment to promote tumor progression, and (c) reducing the effector functions of immune cells such as CD8+ T cells and NK cells to promote immune evasion and immune suppression [63,66,67]. Here, CD8A is linked to neoplasm.