Nevertheless, higher NPM1 expression in IGHVUNMUT cases in comparison to IGHVMUT cases was reported earlier by Rees-Unwin et al. [20] The altered expression of NPM1 in IGHVUNMUT CLL might contribute to changed protein biosynthesis, as NPM1 regulates the activity of ribosomal proteins. Here, NPM1 is linked to B-cell chronic lymphocytic leukemia.