The investigators hypothesize that Lipoprotein Lipase (LPL) expression on Chronic Lymphocytic Leukemia (CLL) cells will predict a more aggressive clinical course. The results from this proposal will validate the use of a novel antibody developed at Dartmouth-Hitchcock in CLL and will predict CLL patients that have a more aggressive form of the disease. The investigators work will also provide direct evidence that LPL is expressed on CLL cells and provides a critical source of fatty acids required by the CLL cells to grow and survive. Fatty acid metabolism may become a therapeutic target in CLL in the future.

The investigators plan to use a novel antibody developed at Dartmouth-Hitchcock Medical Center to characterize the expression of LPL in CLL. Peripheral blood from CLL patients will be analyzed by flow cytometry to detect the expression of LPL and to investigate if LPL expression correlates with a more aggressive type of CLL. The investigators propose that LPL protein expression on CLL cells is prognostic and that LPL and other proteins involved in fatty acid metabolism are critical for CLL cells to survive.

Inclusion Criteria:

• Diagnosis of CLL as per National Cancer Institute Working Group Guidelines
• Patients undergoing routine blood draws as part of their ongoing follow up for CLL
• 18 years or older
• Ability to provide consent in English
• Patient must have measurable disease as defined by an absolute lymphocyte count greater than 5,000/mm3 or have archived lymph node or bone marrow with CLL involvement.

Exclusion Criteria:

• Patients who have received cytotoxic drug, oral or intravenous steroid or targeted antibody therapy for their CLL,
• other hematologic malignancy or other disease process within the past 6 months are excluded.

Patients at Dartmouth-Hitchcock Medical Center's Norris Cotton Cancer Center with CLL