What needs to be known¶
Management of newly diagnosed CLL or SLL depends on more than the diagnosis itself: the exact diagnostic label, the stage, the blood counts, the genetic markers TP53 and IGHV, and other illnesses and medicines all matter. The table lists what needs to be known, why each item matters and where the information comes from.
[I] If the diagnosis was made on excised lymph nodes, the pathology report carries unusual weight. Diagnosis by lymph-node excision is the less common route: in Sweden, 73% of patients diagnosed in 2020–2024 were diagnosed on blood alone, compared with 41% in 2007–2008 (KLL registry report 2025, p. 21) [E].
| What needs to be known | Why it matters | Where it comes from |
|---|---|---|
| Region of residence | Determines clinics, referral rules, vaccine costs and travel-reimbursement rules; the regional details in this knowledge base are for Skåne | — |
| The exact diagnosis, in writing: CLL, SLL or tissue-based MBL | CLL, SLL and tissue-based MBL are managed differently in registries and trials | Written diagnosis; PAD |
| Pathology details (proliferation centres, Ki-67, large cells, exclusion of mantle cell lymphoma) | Separates typical CLL/SLL, accelerated CLL, Richter transformation and look-alike lymphomas | PAD, immunohistochemistry addenda |
| Clonal B-cell count in blood (flow cytometry) | ≥5×10⁹/L = CLL; <5 with nodes = SLL | Blood flow-cytometry report |
| Blood counts: Hb, platelets, lymphocytes, differential, reticulocytes | Binet C, treatment criterion "marrow failure", autoimmune cytopenias | Lab history |
| Stage (Binet/Rai) | Staging uses palpable areas and blood counts only; the stage cannot be inferred from node involvement | Clinical examination |
| Imaging and spleen size | Bulky/massive disease criteria; TLS risk if venetoclax is ever used | Radiology reports |
| Symptoms (fever, night sweats, weight loss, fatigue) | Treatment criterion | Doctor's notes |
| TP53/del(17p), FISH panel, IGHV | Treatment selection and prognosis | Genetics reports (often only before treatment in Sweden) |
| Age, heart, kidney and other comorbidities; medications | Drug choice, interactions, vaccine eligibility, prognosis | Records, medication list |
| Immunoglobulins, infection history, hepatitis B status | Infection risk, prophylaxis, vaccination | Lab results |
| Responsible clinic, SVF status, proposed plan | Who is accountable | Ask the clinic |