CLL/SLL two sides of the same coin...

[Cllcanada]

CLL/SLL is both a leukemia and a lymphoma and is classified under the WHO and REAL systems as a Non-Hodgkin's Lymphoma.

Chronic lymphocytic leukemia (CLL) is classified as a leukemia because it primarily affects the blood and is characterized by an elevated white blood cell count.

Its lymphoma counterpart, small lymphocytic lymphoma (SLL), infiltrates the lymphatic system, but does not affect the white blood cell count because only a small number of these cells circulate in the blood.

Source... cllglobal.org/pastArticles/...

[AussieNeil Administrator]

One major difference between SLL and CLL is that SLL can be cured by targeted radiation IF caught early enough (i.e. when limited to no more than a few swollen lymph nodes).

Also, due to the vagaries of treatment approval mechanisms, in some countries a diagnosis of SLL may open the doors to approved/government subsidised treatment not available for those with a CLL label - despite exactly the same drugs/drug regime being applicable. (This was the case in Australia before FCR was approved for CLL.)

When I was diagnosed as SLL/CLL, and given a RAI stage IV CLL staging, my ALC was below the CLL ALC cut-off point of 5.0, so I technically had SLL, not CLL. (This arbitrarily selected value, chosen by some key CLL researchers has since been confirmed as a valid discrimination point, for what it is worth.) My ALC has since climbed into the CLL region as I follow the general trend of those with SLL of moving into a CLL presentation as the cancer progresses.

I also checked my median survival time both SLL and CLL using the Ann Arbor and RAI staging methodologies respectively and they were virtually identical despite the different selection criteria - which is what you'd expect if they are the same disease.

[Cllcanada Top Poster CURE Hero]

There are few direct comprisons between CLL and SLL but one was presented at a poster session at ASH 2011. See the table for differnces.

Link here

abstracts.hematologylibrary...

The study was age matched which is interesting and the sample of CLL patients was far larger than SLL patients, which would be expected.

The study found in the follow up of the two groups that overall survival was the same, as was the cause of death.

Where they differed.... SLL had more secondary cancers, excluding non melanoma cancers, more frequnt cytopenias and a higher 10-year risk of Richter Syndrome CLL 5.3%

SLL 32.8%

I caution, this is one study, but it does reveal some differences between CLL and SLL and more work is needed on these comparisons.

~chris

[AussieNeil Administrator in reply to Cllcanada]

Thanks Chris,

Very interesting. I certainly fit in the cytopenia category...