PBMCs from different CLL patients were cultured in vitro for 48 hours. Viability of CLL cells was analyzed by flow cytometry after 48 hours. Difference in viability of samples from (A) VLA-4 low (n = 18) and high-risk (n = 10; Unpaired t-test, p = .0004) patients and (B) and of CD38 low (n = 19) and high-risk (n = 9; Unpaired t-test, p = .0005) patient samples. (C) Difference in viabilty after 48 hours of cells from patients with a combined low risk (−/−, VLA-4-/CD38-, n = 17), with discordant VLA-4 and CD38 risk (+/−−/+, n = 3), and with combined high risk (+/+, VLA-4+/CD38+, n = 8, ANOVA, One-way analysis of variance, p = .0007, Bonferroni's multiple comparison test). ***, P<.001.