It doesn’t matter why something happens.

It doesn’t matter why something happens.

Why you got cancer or why you lost your hair
or why you got into a car accident.

What matters is what you do with it.
What matters is how you use it.
What matters is getting your life back.

And since all you have to work with is who you are
and what you’re given,
you might at well use them.

We are more than our hair, our faces, our bodies, our relationships.
But we will never know that
until we understand the images
that keep us from remembering ourselves.

When they are recognized, they dissolve.
And when they dissolve,
we become that much freer
to be the vastness of who we are.

Geneen Roth

CLL? SLL?

Over the last 6 or 8 weeks, I had been asking questions such as: What is a small clonal population and what does that mean? Why are my counts (WBC & ALC) in the normal range? Without lymphocytosis, can this be CLL? If not, then what is it?"

I requested quantitative reports from Beth Israel Deaconnes Medical Center in Boston where the diagnosis was done last summer. They were waiting for me when I returned from Canada and I discovered some answers to some questions:

• The bone marrow biopsy/aspirate showed 33% lymphocytes -- that answers the "small clonal population" question as according to MD Anderson, "lymphocytes >30% are diagnostic for CLL.
• The flow cytometry studies showed the "presence of a Kappa restricted CD20 dim, CD23+, CD5 B-cell population that is immunophenotypically consistent with involvement by chronic lymphocytic leukemia/small cell lymphocytic lymphoma."
• CD38 expression is not detected (and that is a good thing!!!!)
• CD5+ B-cells express ZAP-70 (not a good thing ---- but ---- it could be a lab error)
• Molecular cytogenetic - four DNA probes -- all in normal ranges (another good thing)

So here is what I now understand: CLL and SLL are biologically and morphologically the same disease but present differently: CLL in the blood and SLL in the lymphatic system.