Small lymphocytic lymphoma is one type of non-Hodgkin lymphoma (NHL). From a practical viewpoint doctors divide all the various types of NHL into one of three groups: low grade, intermediate grade or high grade. This division is based on the appearances under the microscope and helps predict how the condition will behave.
Low grade NHLs usually have a relatively slow growth rate, running a long course and often needing little or no treatment for months or possibly years. When they do need treatment they respond well but are likely to come back again at some time in the future. They frequently respond to treatment on several occasions over the years but may eventually become resistant or transform to a high grade form of NHL.
High grade types of NHL usually grow more rapidly and behave more aggressively and so need prompt treatment. Despite this they are more likely to be completely cured than low grade NHLs. Around half of all people with high grade forms of NHL will be cured by the use of intensive chemotherapy.
Intermediate types of NHL lie somewhere between these two extremes in their behaviour.
As the precise characteristics of each of the individual subtypes of NHL are becoming better understood this 'working' classification is gradually giving way to the idea that the various subtypes of NHL are different conditions in their own right. Each of these will have different patterns of behaviour and may need different approaches to treatment.
Small lymphocytic lymphoma is a low grade lymphoma and accounts for about 4% of all cases of NHL.
Small lymphocytic lymphomas often progress very slowly and if the disease is causing no symptoms it may not be necessary to give treatment immediately . The person would then be seen regularly by their doctor and treatment would be given only when significant symptoms or clinical problems arose. It could be some years before this happened. Treatment is with chemotherapy. Small lymphocytic lymphoma is usually very sensitive to chemotherapy and often disappears with simple drug treatment. This is frequently given in tablet form, using a drug called chlorambucil, or with a drug called fludarabine, which is given by injection into a vein.
Although treatment normally leads to a rapid remission small lymphocytic lymphoma usually comes back again, although it may be years before it reappears. Further chemotherapy can then be given and several further remissions may be obtained. This means that the majority of patients can have their disease controlled, and lead a relatively normal life, often for many years. In some people their lives are not shortened at all by having this type of lymphoma.