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Environmental or self-antigens and homotypic interactions cause BCR and Toll-like receptor (TLR) signaling, amplifying the response of CLL cells to other indicators within the microenvironment and escalating the activation of anti-apoptotic and proliferation pathways.31,32 Genomic experiments have identified recurrent mutations in genes regulating tumor cell-microenvironment interactions, that are by now needed for tumor cell development. So, NOTCH1 mutations are dependent on the existence of Notch ligands inside the microenvironment and activate procedures for example mobile migration, invasion and angiogenesis.
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