Indeed, after first-line treatment with fludarabine monotherapy (F) or fludarabine and cyclophosphamide (FC) in the CLL4 trial, conducted by the German CLL study group (GCLLSG), the overall survival (OS) of CLL patients was markedly shorter in patients harboring TP53 mutations, compared with those without (median OS, 23.3 versus 62.2 months) (11, 12). Here, TP53 is linked to B-cell chronic lymphocytic leukemia.