IntroductionChronic lymphocytic leukemia (CLL) is the most prevalent type of adult leukemia and has an extremely heterogeneous natural history. Approximately 90% of patients are older than 50 years, with the median age of 72 years at diagnosis. 1 CLL is characterized by clonal overgrowth of CD5-, CD19-, and CD23-positive B cells. 2,3 Prognostic factors, including IgV H gene mutational status, ZAP70 expression, cytogenetic abnormalities, and a variety of other biomarkers, have been applied to predict survival of patients with CLL. However, our understanding of environmental or molecular initiating events associated with CLL progression is limited, in part because of our inability to serially study the process of leukemia transformation and the importance of genes found to be silenced in tumor cells versus normal B cells. Developing novel strategies to address these obstacles will contribute enormously to our knowledge of disease initiation and progression.The recent introduction of several mouse models of CLL (reviewed in Pekarsky et al 4 ) provides important tools that could be used to determine the importance of loss or gain of function of genes in human CLL. The TCL1 oncogene is expressed in approximately 90% of human CLL cells. Transgenic mice with E-driven, B cell-specific expression of TCL1 5 initially are healthy but gradually develop a B-cell leukemia with features of human CLL. These include unmutated IgV H status, increased expression of Bcl-2, epigenetic silencing by methylation, and aberrantly expressed microRNA genes mmu-mir-15a and mmu-mir-16-1, as has been described in human CLL. [5][6][7][8][9] In addition, the disease phenotype includes expansion of nonclonal B1 lymphocytes at 3-5 months with eventual transformation to a mature B-cell leukemia very similar to human CLL. With disease progression, enlarged lymph nodes, spleen, liver, and elevated blood lymphocyte counts are noted, ultimately resulting in death at a median of 11 months. 5,8 Data recently published by our group demonstrate that the E-TCL1 transgenic mouse also has a pattern of epigenetic silencing similar to human CLL. 9,10 Collectively, these characteristics indicate that the E-TCL1 mouse model of CLL is a useful tool for defining the relevance of novel genes found to be uniformly silenced in CLL compared with normal B cells.Inhibitor of DNA binding protein 4 (ID4) is a member of the dominant-negative basic helix-loop-helix (bHLH) transcription factor family (ID1-4). 11 Members of this family lack a DNA binding domain but retain the ability to bind and thus inhibit the function of other bHLH proteins. Such binding predominately results in a tumor suppressor role of ID4 in colorectal, 12 prostate, 13,14 and gastric 15 cancers, whereas in breast 16 and bladder 17 cancer, it has oncogenic features. [16][17][18] In a study that used an interleukin-15 transgenic mouse model of natural killer (NK) cell leukemia, the authors demonstrated that ID4 was silenced by methylation in transformed lymphocytes. 19 Studies with YAC-1 lymphocytes tran...