Small Lymphocytic Lymphoma (SLL)

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Small Lymphocytic Lymphoma (SLL)?

Small Lymphocytic Lymphoma (SLL) is a slow-growing non-Hodgkin lymphoma from mature B-lymphocytes, identical to chronic lymphocytic leukaemia (CLL) but primarily nodal (lymph nodes) rather than blood/bone marrow dominant. It comprises 5-7% of NHLs, with ~4,000-6,000 US cases annually in 2025, median age 65, more in men. SLL is indolent but can transform to aggressive DLBCL (Richter transformation, 2-8%).

Symptoms

Many are asymptomatic, diagnosed incidentally. When present, symptoms include painless swollen lymph nodes (neck, armpits, groin), fatigue, weight loss, night sweats, fever, recurrent infections (from immune dysfunction), abdominal fullness (splenomegaly), and easy bruising (thrombocytopenia). Advanced SLL causes anemia symptoms (pallor, shortness of breath) or B symptoms.

Causes

Causes involve genetic mutations (e.g., TP53 del(17p) for aggressive), with unknown triggers. Risk factors include age, male gender, family history, and exposures (pesticides, Agent Orange). In 2025, epigenetics and microenvironment are key.

Diagnosis

Diagnosis uses lymph node biopsy (small lymphocytes, CD5+/CD23+), flow cytometry for clonality, CBC for lymphocytosis, and FISH for chromosomal abnormalities (del(13q), trisomy 12). Bone marrow biopsy assesses involvement. In 2025, NGS identifies IGHV status.

Treatment

Watch and wait for asymptomatic; treatment for symptomatic uses BTK inhibitors (ibrutinib), BCL2 inhibitors (venetoclax), or rituximab. Chemoimmunotherapy for fit patients. In 2025, fixed-duration venetoclax + obinutuzumab achieves deep remissions.

Future Outlook

In 2025, 10-year survival is 50-60%, with many not needing treatment. Targeted therapies improve outcomes. By 2030, CAR-T could achieve 70% survival.

Sources

The information for SLL is sourced from Mayo Clinic’s “Small lymphocytic lymphoma – Symptoms and causes” for symptoms; Cleveland Clinic’s “Small Lymphocytic Lymphoma (SLL)” for treatment; NCI’s “Small Lymphocytic Lymphoma Treatment” for diagnosis; Healthline’s “Small Lymphocytic Lymphoma: Symptoms, Causes, Treatment” for overview; and PMC’s “Advances in Small Lymphocytic Lymphoma” for future outlook.