Small lymphocytic lymphoma/ chronic lymphocytic leukemia (SLL/CLL) typically occurs in individuals between 65 and 70 years of age and is almost always diagnosed at an advanced stage disease typically involving the bone marrow. When the majority of cancer involves the blood and bone marrow, doctors refer to the disease as chronic lymphocytic leukemia. However, when the cancer chiefly involves the lymph nodes, it may be referred to as small lymphocytic lymphoma. Chronic lymphocytic leukemia is the most common adult leukemia and together with small lymphocytic lymphoma account for 6%-10% of all cancers involving the lymph system.

Chronic lymphocytic leukemia is a cancer that involves abnormal, mature lymphocytes of the body. There is a marked increase in the number of abnormal lymphocytes due in part to prolonged cell survival. This is not a rapidly growing cancer but the abnormal cells accumulate in blood, bone marrow, lymph nodes and spleen, resulting in enlargement of these organs and decreased bone marrow and immune function. This disease interferes with the normal production of antibodies and immunoglobulins, so the body cannot properly fight infections.

SLL/CLL has other unique features that are not present in other kinds of leukemia. SLL/CLL may be associated with immune mediated destruction of red blood cells and platelets. These are referred to as autoimmune mediated cytopenias. Patients with SLL/CLL may also experience repeated infections from low levels of normal immunoglobulin production.

In addition to the histologic classification of SLL/CLL, it is important to determine the stage or where the cancer has spread in the body. All new treatment information is categorized and discussed by the stage, or extent, of the disease. Determining the extent of the spread or the stage of the cancer requires a number of procedures including CT/MRI scans and blood tests. The goal of staging is to determine which patients have early and which have advanced stage cancer. In order to learn more about the most recent information available concerning the treatment of SLL/CLL, click on the appropriate stage.

Stage I : Cancer is found only in a single lymph node, in the area immediately surrounding that node, or in a single organ.

Stage II : Cancer involves more than one lymph node area on one side of the diaphragm (the breathing muscle separating the abdomen from the chest).

Stage III : The cancer involves lymph node regions above and below the diaphragm. For example, there may be swollen lymph nodes under the arm and in the abdomen.

Stage IV : Cancer involves one or more organs outside the lymph system or a single organ and a distant lymph node site.

In some patients, the leukemia may grow out of the lymph system into adjacent organs. This is referred to as extranodal extension and designated by an " E " following the stage. For example a patient with a stage II lymphoma that extended into the lungs would be referred to as stage IIE.

Patients with SLL/CLL may also experience general symptoms from their disease. Patients with fever, night sweats or significant weight loss are said to have " B " symptoms. If these specific symptoms are not present, patients are further classified as " A ".

Relapsed/Refractory : The cancer has persisted or returned (recurred/relapsed) following treatment.