Foreign antigens or autoantigens could prompt normal B lymphocytes to become B-CLL cells by selecting B-cell clones with restricted BCRs (possibly unique to B-CLL) is largely unknown, although currently under investigations. It may be they result from infections due to a specific microbe common among patients, which has been found for gastric lymphomas. Alternative possibilities are that both environtmental and autologous antigens may be involved. Indeed, it appears that intermitten and interchangeable encounters with microbial antigens and autoantigens, especially those generated during cell death and oxidative and other forms of stress, are key.
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