TERT and B-cell chronic lymphocytic leukemia: However, epigenetic changes of TERT by methylation remain a controversial topic: Bechter et al. demonstrated that in patients with B-CLL, TERT promoter hypomethylation was associated with an increased telomerase activity [44], whereas others showed that TERT hypermethylation increases TERT mRNA expression and telomerase activity in a variety of cancers (e.g., bladder, brain, colon, heart and kidney) [45].