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Whole\u2010genome and whole\u2010exome sequencing studies have revealed recurrently occurring somatic mutations in some genes. Several other prognostic markers have previously been tested for their prognostic value in <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content>. <jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic> is among these markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate <jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic> gene expression together with the well\u2010established prognostic markers of <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content> and investigate correlations with more recently identified prognostic markers, <jats:italic><jats:styled-content style=\"fixed-case\">NOTCH<\/jats:styled-content>1<\/jats:italic> and <jats:italic><jats:styled-content style=\"fixed-case\">TP<\/jats:styled-content>53<\/jats:italic> mutations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>On 149 patients, <jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic> gene expression was analyzed by real\u2010time <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>. Exon 34 of <jats:italic><jats:styled-content style=\"fixed-case\">NOTCH<\/jats:styled-content>1<\/jats:italic> was <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>\u2010amplified and directly sequenced.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic> gene expression could be measured as a categorical variable (<jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic>+\/<jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic>\u2010) and was associated with time to treatment (<jats:italic>P<\/jats:italic> &lt; 0.001) and overall survival (<jats:italic>P<\/jats:italic> = 0.007). In patients otherwise classified as having a good prognosis according to established and new prognostic markers, 3 of 4 patients, who received treatment within 24 months after diagnosis, were <jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic>+ (<jats:italic>P<\/jats:italic> = 0.03). There was a strong correlation between <jats:italic><jats:styled-content style=\"fixed-case\">NOTCH<\/jats:styled-content>1<\/jats:italic> mutation and <jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic>+ (<jats:italic>P<\/jats:italic> = 0.005). The unfavorable prognosis of <jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic>+ was maintained in <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content> with wild\u2010type <jats:italic><jats:styled-content style=\"fixed-case\">NOTCH<\/jats:styled-content>1<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic><jats:styled-content style=\"fixed-case\">NOTCH<\/jats:styled-content>1<\/jats:italic> mutations are tightly associated with <jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic> gene expression. <jats:italic><jats:styled-content style=\"fixed-case\">LPL<\/jats:styled-content><\/jats:italic> expression is independently associated with poor outcome in <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content> and can be measured as a categorical 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