CLL and SLL: Differences and overlaps explained

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (LLL) are two types of non-Hodgkin lymphoma that affect lymphocytes. Lymphocytes are a type of white blood cell.

The two cancers are so similar that healthcare professionals often group them together as LLC / SLL. Due to the similarity between the two conditions, there is no difference in how doctors approach their treatment.

This article discusses the differences between CLL and SLL and describes the similarities between the two.

Both CLL and SLL are types of indolent non-Hodgkin lymphoma. This means that they slowly spread cancers that start in the white blood cells and affect the lymphatic system.

The lymphatic system is a network that is part of both the circulatory system and the immune system. It carries a watery fluid called lymph throughout the body. Lymph contains, among other things, white blood cells.

According to National Cancer Institute, CLL and SLL both cause an effect of immature white blood cells on the immune system and are the same condition. The main difference is which part of the immune system is affected by cancer.

Different locations

If a person has CLL, cancer cells appear above all in the blood and bone marrow. Bone marrow is the spongy tissue inside the bones. This tissue plays a role in the production of blood cells.

If a person has SLL, cancer cells mainly affect the lymph nodes. Lymph nodes are glands that filter waste products and contain white blood cells. They help the immune system protect the body from infections.

Cellular differences

Cancer cells in CLL and SLL look the same under a microscope.

However, a person with LLC will have more than 5,000 monoclonal lymphocytes per cubic millimeter (mm³) in the blood, and a person with SLL will have less than 5,000 monoclonal lymphocytes per mm³.

CLL is the The most common type of leukemia in adults, representing 7% new diagnoses of non-Hodgkin lymphoma.

Combined, the rate of new cases of LLC and SLL is 4.6 per 100,000 males and females per year. In addition, the number of new cases fell by 1.8% between 2009 and 2018.

CLL / SLL primarily affects the elderly. The median age of people diagnosed is 68.

In 50-75% of newly diagnosed cases, a person will not have any symptoms. it may take several years before a person has symptoms of cancer.

When cancer begins to cause symptoms, a person may experience the following:

People with SLL may also notice swollen glands in the neck, groin, or armpits.

Learn more about CLL and stomach pain here.

CLL and SLL progress slowly. it may take several years for symptoms to appear.

In the United States, doctors and researchers generally follow the Rai classification system, which classifies CLL as five steps:

  • Step 0: There is an increase in the number of white blood cells and an almost normal number of red blood cells and platelets, but no enlarged lymph nodes, spleen, or liver.
  • Step 1: There is an increase in the number of white blood cells but a near normal number of red blood cells and platelets and enlarged lymph nodes.
  • 2nd step : The number of white blood cells is increased, but the number of red blood cells and platelets is close to normal. There is also an enlarged spleen and possibly an enlarged liver and lymph nodes.
  • Step 3: There is an increase in the number of white blood cells with a low number of red blood cells and normal platelets. The lymph nodes, spleen and liver may or may not be enlarged.
  • Step 4: There is an increase in the number of white blood cells with low or near normal red blood cell count and low platelet count. The lymph nodes, spleen and liver are enlarged.

Learn more about CLL and lymphocyte count here.

The treatment of SLL and LLC is identical. However, there may be differences depending on several factors, such as:

  • a person’s age
  • their general health
  • their symptoms
  • stage of cancer

A doctor may recommend several treatment options, including:

A doctor may recommend additional treatment options for cancer complications. This can include antibiotics to fight infections and additional treatment to treat symptoms such as fatigue.

There is no cure for SLL or LLC. However, treatment can help improve a person’s quality of life and slow the progression of cancer.

Cancer progresses slowly over several years. Early stages or asymptomatic cases do not require treatment.

After symptoms appear, a doctor will usually discuss with someone the best treatment options for them. Treatment can help extend their lifespan and treat symptoms.

Learn more about survival rates for LLC here.

Studies and several organizations, including the Lymphoma Research Foundation, indicate that SLL and CLL are two manifestations of the same cancer. The main difference is where the cancer grows and presents itself.

As a result, doctors will generally classify cancer as SLL or CLL, not both.

CLL and SLL are two different manifestations of the same cancer. They share symptoms, potential causes, and treatments.

However, they differ in the areas they affect. CLL primarily affects the blood, while SLL usually affects the lymph nodes.

Treatment may vary depending on a person’s general health, age, and stage of cancer. With treatment, individuals can live long and healthy lives.


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