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CLL Support Association
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Small lymphocytic lymphoma (SLL)

Yesterday I spent a little while looking at the peculiarities and similarities of CLL and SLL and found a great article by the late Professor Hamblin, further reviewed by CLL Topics in patient friendly language SLL Versus CLL: How Different Are They?. updates.clltopics.org/1993-...

I am on a quest to find current reviewed patient friendly writing about SLL, has anyone got any favorites that may help others?,

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The MOST IMPORTANT difference between CLL and SLL is that as Terry Hamblin pointed out, SLL may be CURED if caught early enough when it is confined to a few nodes that can be dealt with by targeted radiation treatment. (I'm ignoring the much higher risk possible cure for CLL of a Stem Cell Transplant.) Unfortunately, as is pointed out in the references below, SLL is generally diagnosed at a much later stage than CLL, as the growing nodes aren't usually obvious until SLL has become more systemic. It seems that the possibility of a cure for SLL is also not well known by oncologists and probably even haematologists, which is a good reason to try and a specialist that specialises in SLL/CLL if that is at all possible.

Dr Sharman provides a good but brief patient friendly overview of SLL in his article


The SLL section includes a link to his CLL topics.

Some far more detailed, though not as patient friendly references were included in Al Janski's recent CLL posting regarding Ibrutinib lymphocytosis: SLL vs. CLL to the Yahoo CLLResearch Health Group:


Terry Hamblin's blog gets two mentions and the Santos/O'Brien paper is pretty thorough.

REFERENCES from Al Janski's posting:

1. "Small lymphocytic lymphoma and chronic lymphocytic leukemia: are

they the same disease?"; Santos FP, O'Brien S.; Cancer J. 2012


Abstract : tinyurl.com/9w9ys7d


"It is suspected that differential expression of chemokine receptors

(e.g., reduced expression of R1 and CCR3 in SLL cells), integrins

(e.g., CLL cells have lower expression of integrin L 2), and genetic

abnormalities (a higher incidence of trisomy 12 and lower incidence

of del(13q) is found in SLL) may explain some of the clinical

differences between these 2 disorders. However, there is still a

lack of knowledge on the precise biological basis underlying the

different clinical presentations of CLL and SLL. It is expected that

future studies will shed light on the pathophysiology of both disorders."

2. "SLL"; Posted by Terry Hamblin; Sunday, January 31, 2010


"Is it known why SLL behaves differently to CLL? Not completely, but

we do have some clues. Lymphocytes move in response to chemicals

called chemokines. We know that CLL cells have more chemokine

receptors than SLL cells."

3. "MBL versus SLL"; Posted by Terry Hamblin; Thursday, May 26, 2011


Re: "Reassessment of small lymphocytic lymphoma in the era of

monoclonal B-cell lymphocytosis"; Haematologica. 2011 Aug;96(8):1144-52.


Dr. Hamblin: "The only histological parameter that was associated

with progression/treatment was the presence of proliferation centers,

which were found in all 12 patients who progressed or required

therapy but in only 9/18 (50%) of patients who did not progress.

There was no significant difference in CD38 or ZAP-70 expression

between those who did or did not progress or require therapy. So,

what they are saying is that there is less likely to be progression

in SLL if there is no lymphadenopathy on CT scanning and there are no

proliferation centers in the lymph node biopsy."



Hello! I know this thread is really old, but I am looking at possible sll mbl. How do I find out if I have proliferation centers?


In 15 years I haven't met a single SLL patient that was diagnosed early enough to be treated.

Hypothetically it may be possible to irradicate it, but how often does this actually happen, if ever.

Clearly, people need to be proactive and seek medical attention for tiny lumps... however they go to their GPs and he hands then antibiotics...for some unknown infection.

Far too common...

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And I've still got my lump mid thigh that my GP dismissed years before my SLL diagnosis as something of no consequence and my haematologist subsequently said was a swollen lymph node. It hasn't changed much in size, but I will always be wondering 'what if'...

The Australian Leukaemia Foundation reckons GPs here see on average 6 - 7 CLL patients in their entire practice history, so you just have to hope that you get the right timing or a less dismissive GP.


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That’s exactly what happened to me In 2006! Antibiotics for a salivary gland infection little lump on jaw was actually first stage SLL!


Thanks for doing this work and providing these links Neil,

Thanks Chris it must be rare. ( :

The latest British Committee for Standards in Haematology, Guidelines on the diagnosis, investigation and management of chronic lymphocytic onlinelibrary.wiley.com/doi...

They also confirm “The rare patient in whom SLL is diagnosed following biopsy of an enlarged lymph node in the absence of detectable disease at any other site, may be offered local radiotherapy with curative intent."


It was a shame you could not attend the conference at Liverpool, Dr Pettit was most helpful in explainng things in a way that we could easily understand and answered questions in an open manner.it was also good to meet people face to face and compare notes and experiences with them, I strongly recomend you try and make the next one.I hope to see you there.


Thanks for your feedback from the day, I was disappointed I was unable to make Liverpool and very pleased that you found the day helpful. Meeting other patients in real time and learning from each other and expert speakers does make a difference. (it has for me), I hope we get to meet too at the next..

You may be interested to know, It was the UK's CLL research community's gathering today at the UK CLL Forum's Annual Scientific Day, where Professor Pettitt was awarded The Annual Catovsky Prize by the Forum in recognition of the outstanding contribution that he has made with his recent Clinical Research studies treating 17p deleted CLL..



This rare Spanish study from ASH 2011, compares CLL to SLL in an age match population...

Table of comparisons





My SLL was casually revealed after more than 2 years of 'CLL diagnosis'....the Doctors here acted as if the two usually 'go together' that usually when you find one you find the other....I was being 'treated' for C-Diff (a miserable 8 months) when they decided I had the C-diff because of the CLL-SLL....with a compromised immune system, it's hard to fight just about anything in the region...


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