Recently, a combined analysis of peripheral blood CLL cells from patients at baseline and after 3 months of treatment with ibrutinib, together with in vitro experiments to mimic lymph node microenvironment using BCR or CD40 stimulation, suggested that metabolic changes involving purines, glucose and glutamate, with emphasis on amino acids as a TCA fuel, could play role in CLL cells in lymph nodes [79]. The gene discussed is CD40; the disease is B-cell chronic lymphocytic leukemia.