SLL - can it be detected with a blood test?

[mantana]

If I understand correctly (please correct me if I'm wrong) - SLL and CLL are the same disease, but they have different manifestations:

- in case of SLL, malignant B cells mostly stay in lymph nodes; one can have seemingly normal blood counts, but growing SLL in lymph nodes; as the disease progresses, blood counts will become abnormal (lymphocyte count growth) and the disease will be eventually classified as CLL

- in case of CLL, malignant B cells are already present in blood; blood counts will be abnormal, typically lymphocyte counts will be increased

In case of SLL with "normal blood counts" (absolute lymphocyte count within the norms) - can the disease be detected and diagnosed with a blood test (like flow cytometry)? Or must one do lymph node or bone marrow biopsy for a correct diagnosis?

[AussieNeil Partner Administrator]

An SLL diagnosis requires less than a count of 5.0 B-lymphocytes, (with some sources requiring the count being just monoclonal B-lymphocytes). So provided you have sufficient monoclonal B-lymphocytes in your blood for the immunophenotype flow test to detect them, you can have an SLL diagnosis from a blood test. Worked for me!

Neil

[Coffeejenny]

My bloods were normal I and I was regularly donating platelets as all tests fine.My cll diagnosed with lymph node biopsy after what I thought were bites on my neck refused to go away.

[SofiaDeo]

If everything appears otherwise "normal" a lymph node biopsy may be needed. Some people will have obvious markers in the blood, other may only have it in nodes, initially. I can imagine there will be patients who have disease in their nodes a biopsy would show, while their blood doesn't yet show CD5/CD19. And vice versa. I have read that at least some patients required a CT scan to identify large internal nodes, which were biopsied & gave the diagnosis.

leukaemia.org.au/blood-canc...

[TheFrog]

Mantana,

I have SLL and it was diagnosed by a biopsy of a lymph node which confirmed SLL, I then had a CT scan to check how my internal nodes were (I had obvious enlarged nodes in my neck and groin) and finally a BMB with confirmed significant infiltration of my bone marrow. My ALC from my blood test was normal and this has continued to be the case for the 27 years that I've had SLL.

The only indicators I've had from blood tests were during my first relapse when I had very low neutrophils, platelets and red count.

SLL can stay well hidden for years which is why we tend to be diagnosed at a much later stage than people with the CLL presentation.

Jacques

[Ladylin151]

My husband was fighting an undiagnosed infection and starting to be more ill. They found the affected lymph nodes in a cat scan and started digging deeper. The final diagnosis was from a biopsy.

[Flute117]

My SLL first came to light when a routine cardiac calcium scoring CT showed lung nodules. After further CT and PET scans, a biopsy of a lymph node in my neck confirmed SLL. All blood work was completely normal at that time.

[Judyanne]

Hi Mantana, I was diagnosed with MBL in 2013, SLL in 2016 when the doctor felt my enlarged spleen and MZL in 2018 when I had a biopsy.

[Hidden]

Nucleated red blood cell test. Even 1/1000 should inspire more investigation