Small Lymphocytic Lymphoma (SLL): Causes, Symptoms and Treatment

Overview

Every person has a type of white blood cell known as a lymphocyte that helps fight infections. But when cancer develops in these lymphocytes, it is known as small lymphocytic lymphoma (SLL). It is a slow-progressing cancer of the immune system. You may produce several ineffective lymphocytes that multiply in your lymph nodes. 

The blog explains small lymphocytic lymphoma, its causes, symptoms, diagnosis, and treatment options. 

What is Small Lymphocytic Lymphoma?

As mentioned above, this slow-growing cancer affects the infection-fighting white blood cells. In this type of cancer, your white blood cells have several ineffective lymphocytes that multiply in your lymph nodes. These pea-sized lymph nodes are present in various parts of your body, such as the legs, armpit, groins, and other body parts that are a part of your immune system. This tumor is a form of non-hodgkin’s lymphoma.

SLL is confused mainly with chronic lymphocytic leukemia (CLL). CLL occurs in the blood, whereas SLL is present in the lymph nodes. But it is most likely that CLL can develop into SLL as the cancer progress and spreads.

As SLL grows slowly, you may not present any signs or symptoms for a long time. Your doctor may accidentally diagnose the conditions when looking for other health conditions. 

What are the symptoms of Small Lymphocytic Lymphoma?

You may not show symptoms for several years. However, when you start to exhibit signs, they are as follows:

• Painless swelling in the neck, armpits, and groin
• Extreme fatigue
• Unexpected weight loss
• Fever
• Night sweats
• Swollen, tender belly
• A feeling of fullness
• Easily bruising and skin lesions
• Loss of appetite
• Shortness of breath

What are the Causes of Small Lymphocytic Lymphoma?

Experts are unsure of the cause of small lymphocytic lymphoma. However, sometimes the disease is inherited, though there is no scientific evidence to prove the responsibility of a single gene. Most changes in the DNA occur during the lifetime of a person. It is primarily diagnosed in people 70 years and above, but it can occur in adults as young as 30. It is rare in children.

The following are certain factors that may increase your chances of developing SLL:

• Old age
• Family history
• Exposure to certain toxic chemicals and pesticides
• A condition that causes your immune system to weaken
• Chemotherapy

When to Seek Medical Help?

If you are experiencing symptoms of small lymphocytic lymphoma, you will need to consult a healthcare provider at the earliest. 

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What are the Different Ways Doctors Diagnose Small Lymphocytic Lymphoma?

After a physical examination and assessing your symptoms, your doctor may recommend  the following tests:

• Biopsy: A small part of your enlarged lymph node is surgically removed to get checked for signs of SLL. The procedure is performed under anesthesia.
• Peripheral blood smear: The blood tests check for the appearance, count, and shape of your red and white blood cells and platelets. The blood tests include complete blood tests, flow cytometry, and others. 
• Bone marrow aspiration: This test helps your doctor determine how advanced your cancer is. Your doctor removes a small part of your bone marrow that is present at the back of your hip bone. The doctor removes the bone marrow with a thin needle.

Your doctor may also suggest other tests, including:

• X-rays, CT scans, and other imaging tests
• Fluorescence in situ hybridization (FISH) test to identify any chromosomal abnormalities
• Flow cytometry is conducted to analyze the blood cells for cell surface markers and identifies circulating cancerous cells. 
• Depending on the number of lymphocytes in your blood, you will be diagnosed with SLL or CLL. If you are an SLL patient, your body has an enlarged spleen or lymph node with less than 5,000 monoclonal or cancerous lymphocytes per cubic millimeter in your blood. In CLL patients, their blood presents at least 5,000 monoclonal lymphocytes per cubic millimeter.

What are the Various Treatment Options for Small Lymphocytic Lymphoma?

Your doctor determines the treatment plan based on your overall health, the severity of your condition, and if your cancer has metastasized. However, your doctor may monitor your cancer’s progress if you are asymptomatic. 

The Lymphoma Research Foundation states that a person needs treatment if they show symptoms or the tests indicate worsening cancer. The following are the various treatment plans:

• Immunotherapy: Your doctor may prescribe medication that boosts your immune system to fight the cancer
• A combination of chemotherapy and immunotherapy: Your doctor treats you with a combination of chemotherapy and immunotherapy.
• Targeted therapy: You will be orally administered medicine that kills or prevents the growth of cancerous tumors. However, this medication causes minimal harm to other noncancerous cells. Oral medications include acalabrutinib, ibrutinib, duvelisib, idelalisib, selinexor, tazemetostat, and zanubrutinib. 
• Stem cell transplants: Due to high doses of chemotherapy, your bone marrow may reduce. Therefore, you may receive a stem cell treatment to replace the lost bone marrow. The therapy prevents infection and allows doctors to continue using stronger doses of chemotherapy to target cancer cells. 
• Monoclonal antibody therapy: These medications mainly target cancer cells that support your immune system to destroy cancerous cells. You administered the medicines intravenously. The medications include alemtuzumab, brentuximab vedotin, ibritumomab tiuxetan, obinutuzumab, polatuzumab vedotin, and tafasitamab. 
• Radiation therapy: This treatment option uses high-energy x-rays and beams to kill and prevent cancer cells. 

Conclusion

If you are diagnosed with SLL, your outlook depends on the stage of your cancer and other factors, such as your health and age. With timely treatment, you can manage the symptoms and the condition. Also, you may have a high chance of reoccurrence and may need several treatment courses to control your cancer. However, with support and medical help, you can continue to lead a normal life. 

Frequently Asked Questions (FAQs)

Is SLL a curable disease?

Unfortunately, it is not a curable disease. However, it is manageable with treatment. 

What are the stages of SLL?

The following are the stages of SLL:

• Stage 1: The cancerous cells are in only one area of your lymph nodes
• Stage 2: More than two groups of lymph nodes contain cancerous cells. These are present on the same side of your body
• Stage 3: Cancer cells are present above and below your diaphragm and spleen
• Stage 4: Cancer has metastasized to other organs in your body, including the liver, lung, or bone marrow