Are small lymphocytic lymphoma and chronic lymphocytic leukemia the same disease? The unsolved dilemma

Abstract

The management of small lymphocytic lymphoma (SLL) as chronic lymphocytic leukemia (CLL) or an indolent non-Hodgkin lymphoma is highly debated. In this single-center, real-life study, 38 SLL patients managed between 2008 and 2022 were evaluated. Overall, 26/38 cases (68.4%) needed treatment and all but one received CLL concordant therapy, including BR (9/38 cases), fludarabine, cyclophosphamide, rituximab (5/38 cases), rituximab and chlorambucil (4/38 cases), BTK inhibitors (7/38 cases) and steroid (1 case with immune thrombocytopenia). Patients treated between 2008 and 2018 were more likely to receive chemoimmunotherapy compared to patients treated in 2019-2022, that were more likely to receive BTK inhibitors. The median PFS was 54 months and 3-y PFS was 58%, while the median OS was not reached, with a 3-y OS of 84%. We confirm a wide heterogeneity in SLL management and we suggest prospective studies are needed to improve the knowledge of its biology and harmonize its treatment.

Keywords:

• chronic lymphocytic leukemia
• non-Hodgkin lymphoma
• treatment
• prognosis

Author contributions

E.C. analysed and interpreted data, performed statistical analysis and drafted the manuscript. A.F.; A.S.; N.C. and A.G. contributed to data analysis and manuscript preparation. M.B. contributed to data interpretation and drafted the manuscript.

Ethics statement

The study was conducted in accordance with applicable local regulations and the principles of the Declaration of Helsinki. All patients provided written informed consent before entry into the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that supports the findings of this study are available at request to the Corresponding Author.