Indeed, the presence of these BcR features, together with NOTCH1, TP53 and CDKN2A mutations or disruption and c-myc activation, indicates a propensity towards RT in patients with CLL, and the concomitant presence of these markers in a patient with RT is indicative of a dire outcome [214,215,216,217]. This evidence concerns the gene MYC and B-cell chronic lymphocytic leukemia.