At the same time, eNAMPT/ TLR4-mediated inflammatory signaling may contribute to the production of tumor-supporting M2 macrophages, which are thought to be involved in tumor occurrence, recurrence, invasion, and metastasis [48, 49], while the use of the immunomodulator lenalidomide can reverse M2 polarization and significantly reduce NAMPT expression in Chronic Lymphocytic Leukemia (CLL) lymphocytes [49]. Here, TLR4 is linked to B-cell chronic lymphocytic leukemia.