Our study also confirmed a previous observation by Jitschin and colleagues [133], who demonstrated that direct interaction of CLL cells with stromal cells induced NOTCH1-related MYC expression and a metabolic shift from mitochondrial respiration to glycolysis (Warburg effect), which can provide growth and survival advantages for tumor cells [145]. The gene discussed is NOTCH1; the disease is B-cell chronic lymphocytic leukemia.