MSH4 and neoplasm: Several DNA damage response genes (i.e., ATM, TP53, CHEK1, CHEK2, ERCC4, BRCA1, FANCA, MSH4, SMC1A, RAD50, and MCM3) have previously been shown to be mutated frequently in CLL and to be associated with advanced tumor evolution, immune surveillance escape, and adverse patient outcomes and chemotherapy responses [8,9,10,11,12,13].