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Understanding the Difference Between SLL and CLL

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Published on March 17, 2017

What is the difference between small lymphocytic leukemia (SLL) and chronic lymphocytic leukemia (CLL)?  Dr. Michael Keating of MD Anderson Cancer Center and Dr. Nicole Lamanna of Columbia University Medical Center explain the similarities and differences between SLL and CLL, including biology, pathology and treatments.

Provided by CLL Global Research Foundation, which received support from AbbVie Inc., Genentech Inc., Gilead Sciences, Pharmacyclics, Inc., Teva Pharmaceuticals and TG Therapeutics. In partnership with The University of Texas MD Anderson Cancer Center.

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Transcript | Understanding the Difference Between SLL and CLL

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

Michael, just one thing on the slide for a minute and I hope if you’re online, you’re watching along with the slides. SLL.

So my friend Derrick Caine up in Halifax, Nova Scotia, Derrick has SLL. What is it?

Dr. Keating:         

Well, as I said, all of the cells are born in the marrow and they then when they reach level of maturity, they’re sent out into the bloodstream. And they all have a ZIP code, and the ZIP codes says that you go to the lymph glands in the neck or lymph glands in the abdomen.

But people get them in funny places. Sometimes, they’re around the ear lobes and sometimes, around the eyelids, and very strange appearances. But that’s usually because there is a protein on the surface that attaches to a receptor protein and traps them. And so that in SLL, they have very strong attachment proteins. So when they circulate around, they go to the lymph gland and stay there, or they go to the spleen, and they stay there.

 

And, in fact, there’s only about 2 percent of the CLL cells in the body not circulating in the bloodstream. So it’s not a very good measure of how much leukemia you actually have. So some people have a very high count and no lymph gland enlargement. Some people will have very big lymph glands and a pretty normal white cell count, and they’re the ones that are called SLL. 

But the biology in the genetics are otherwise identical. 

Andrew Schorr:

B-cell lymphocytes.

Dr. Keating:         

Yeah. 

Andrew Schorr:

Okay.

Dr. Lamanna:      

And that’s important, because I think people get confused. Because when you guys read your own interpretations on your reports, people go, “Do I have lymphoma, or do I have leukemia?” Right? And so these are the same diseases. We don’t want you to get confused, but it often is very confusing because of the way that the pathologist might read your report, so it’s the same.

Dr. Keating:         

See. The pathologist looks at the slides of the tissues that he’s been asked to look at and he says, “Okay. Well, these are all these B cells, and you can be the SLL, or you can be CLL if you have a high white count.” That’s the thing that differentiates the two diagnoses. And if the doctor knows that you have a high white count, he’ll say CLL. If he doesn’t know what your white count is, he’ll just say B-cell small lymphocytic lymphoma on the tissue that he’s looking at.

Andrew Schorr:

Okay. And the treatments…

Dr. Keating:         

Identical.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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