Small Lymphocytic Lymphoma (SLL): Symptoms and Treatments, Causes and Diagnosis

Small lymphocytic lymphoma (SLL) is a cancer of the immune system. It affects infection-fighting white blood cells called B cells. SLL is a type of non-Hodgkin’s lymphoma, which along with chronic lymphocytic leukemia (CLL) indicates the same type of disease, treated the same way. Whereas in SLL, the cancer cells reside primarily in the lymph nodes (both B-type, in 90% of cases, and T-type), in CLL, most of the cancer cells are found in the blood and bone marrow.

In general, non-Hodgkin’s lymphomas, which constitute the largest group, can be classified as indolent or aggressive. Indolent lymphomas (such as the SLL and CLL types we will be discussing) develop slowly, may not cause symptoms, and usually respond well to treatment when it is needed. Aggressive lymphomas progress more rapidly and require more intensive treatments. However, recovery from the disease can often be achieved.

Symptoms of Small Lymphocytic Lymphoma

People with SLL may not have obvious signs for many years. Some may not even realize they have the disease. The main symptom of SLL is painless swelling of the neck, armpits, and groin. It is caused by cancer cells building up inside the lymph nodes.

Treatment of Small Lymphocytic Lymphoma

Immediate treatment does not necessarily affect everyone affected by Small Lymphocytic Lymphoma, as in the absence of symptoms, it is your doctor himself who advises you to wait and progressively evaluate the cancer without any treatment. Upon the occurrence of particular conditions, such as the spread of the tumor or in the presence of certain symptoms, treatment may be started. For example, if the lymphoma is located in a lymph node, radiation therapy is the preferred treatment. The radiation given out uses high-energy X-rays to kill the cancer cells. At a more advanced stage, doctors use chemotherapy drugs such as chlorambucil (Leukeran), fludarabine (Fludara) and bendamustine (Treanda). Sometimes chemotherapy is combined with a monoclonal antibody drug such as rituximab (Rituxan, MabThera) or obinutuzumab (Gazyva). These drugs cause the immune system to seek out and destroy cancer cells.

If the first treatment does not work or stops working, your doctor will repeat the same treatment or have you try a new drug. You can also ask your doctor to enroll you in a clinical trial. These trials test new drugs and combinations of drugs for SLL.