{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:53:07Z","timestamp":1782129187639,"version":"3.54.5"},"reference-count":16,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Small lymphocytic lymphoma (SLL) represents the tissue-based manifestation of chronic lymphocytic leukemia (CLL). Despite their shared biological background, patients with SLL have been underrepresented in CLL-focused clinical trials, and data addressing the clinical behavior of pure nodal SLL remain scarce. The present study aimed to identify factors associated with time to first treatment (TTFT) and progression-only survival in patients with pure nodal SLL. Materials and Methods: In this prospective observational study, 46 patients with pure nodal SLL were included and followed for a median duration of approximately 5 years. Clinical, laboratory, histopathological, and TP53-related parameters were evaluated for their prognostic impact on TTFT and progression-only survival. Results: On univariable analysis, advanced-stage disease, hemoglobin &lt; 10 g\/dL, elevated serum \u03b22M, elevated lactate dehydrogenase, del(17p), and aberrant p53 immunohistochemical expression were significantly associated with shorter TTFT and progression-only survival. Conclusions: Pure nodal SLL is a heterogeneous entity with a variable clinical course. Easily assessable clinical and biological parameters, including TP53 abnormalities, may help predict treatment requirement and disease progression, thereby contributing to better risk stratification and more individualized management. Kaplan\u2013Meier analysis demonstrated significantly shorter time-to-first-treatment (TTFT) among patients with elevated \u03b22M levels (\u22653.5 mg\/L), bulky lymphadenopathy (\u22655 cm), and advanced-stage disease.<\/jats:p>","DOI":"10.3390\/medicina62061200","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:49:55Z","timestamp":1782121795000},"page":"1200","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pure Nodal Small Lymphocytic Lymphoma: Clinical, Pathologic, and Outcome Features in a Single-Center Cohort"],"prefix":"10.3390","volume":"62","author":[{"given":"Andreea Georgiana","family":"Stoica","sequence":"first","affiliation":[{"name":"Faculty of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"},{"name":"Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, \u201cOvidius\u201d University of Constanta, 900591 Constanta, Romania"},{"name":"Department of Hematology, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 900591 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"A\u0219chie","sequence":"additional","affiliation":[{"name":"Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, \u201cOvidius\u201d University of Constanta, 900591 Constanta, Romania"},{"name":"Department of Clinical Pathology, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 900591 Constanta, Romania"},{"name":"Academy of Medical Sciences, 030167 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5191-2585","authenticated-orcid":false,"given":"Miruna","family":"Gherase-Cristian","sequence":"additional","affiliation":[{"name":"Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, \u201cOvidius\u201d University of Constanta, 900591 Constanta, Romania"},{"name":"Department of Forensic Medicine, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 900439 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca Florentina","family":"Mitroi","sequence":"additional","affiliation":[{"name":"Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, \u201cOvidius\u201d University of Constanta, 900591 Constanta, Romania"},{"name":"Department of Clinical Pathology, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 900591 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0202-5933","authenticated-orcid":false,"given":"Georgeta Camelia","family":"Cozaru","sequence":"additional","affiliation":[{"name":"Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, \u201cOvidius\u201d University of Constanta, 900591 Constanta, Romania"},{"name":"Department of Clinical Pathology, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 900591 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u0103d\u0103lina","family":"Bo\u0219oteanu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"},{"name":"Department of Clinical Pathology, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 900591 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Cioti","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"},{"name":"Department of Internal Medicine, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 900470 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5113-0149","authenticated-orcid":false,"given":"Sorin","family":"Deacu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"},{"name":"Department of Forensic Medicine, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 900439 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Tica","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"},{"name":"Department of Internal Medicine, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 900470 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1182\/blood.2022015851","article-title":"The International Consensus Classification of Mature Lymphoid Neoplasms: A report from the Clinical Advisory Committee","volume":"140","author":"Campo","year":"2022","journal-title":"Blood"},{"key":"ref_2","unstructured":"Schuh, A., Coupland, S.E., and Sewell, W.A. (2024). Chronic lymphocytic leukaemia\/small lymphocytic lymphoma. WHO Classification of Haematolymphoid Tumours, International Agency for Research on Cancer (IARC). [5th ed.]. Available online: https:\/\/tumourclassification.iarc.who.int\/chaptercontent\/63\/116."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/S0002-9440(10)64620-2","article-title":"Histological and immunoglobulin VH gene analysis of interfollicular small lymphocytic lymphoma provides evidence for two types","volume":"157","author":"Bahler","year":"2000","journal-title":"Am. J. Pathol."},{"key":"ref_4","unstructured":"Knowles, D.M. (2001). Small lymphocytic lymphoma. Neoplastic Hematopathology, Lippincott Williams & Wilkins. [2nd ed.]."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4648","DOI":"10.1200\/JCO.2006.09.4508","article-title":"Assessment of chronic lymphocytic leukemia and small lymphocytic lymphoma by absolute lymphocyte counts in 2,126 patients: 20 years of experience at the University of Texas M.D. Anderson Cancer Center","volume":"25","author":"Tsimberidou","year":"2007","journal-title":"J. Clin. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1080\/10428194.2017.1397660","article-title":"The mutational landscape of small lymphocytic lymphoma compared to non-early stage chronic lymphocytic leukemia","volume":"59","author":"Pinyol","year":"2018","journal-title":"Leuk. Lymphoma"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/S0140-6736(12)61763-2","article-title":"Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: An open-label, multicentre, randomised, phase 3 non-inferiority trial","volume":"381","author":"Rummel","year":"2013","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/bjh.18879","article-title":"Real-world management of small lymphocytic lymphoma as chronic lymphocytic leukaemia versus an indolent non-Hodgkin lymphoma","volume":"202","author":"Puckrin","year":"2023","journal-title":"Br. J. Haematol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2591","DOI":"10.21873\/anticanres.13382","article-title":"Small lymphocytic lymphoma: Analysis of two cohorts including patients in clinical trials of the German Chronic Lymphocytic Leukemia Study Group (GCLLSG) or in real-life outside of clinical trials","volume":"39","author":"Sachanas","year":"2019","journal-title":"Anticancer Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"942","DOI":"10.3109\/10428194.2014.936013","article-title":"Disparate survival outcomes after front-line chemoimmunotherapy in older patients with follicular, nodal marginal zone, and small lymphocytic lymphoma","volume":"56","author":"Olszewski","year":"2015","journal-title":"Leuk. Lymphoma"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1111\/ejh.14376","article-title":"Underrepresentation of small lymphocytic lymphoma in clinical trials for chronic lymphocytic leukemia","volume":"114","author":"Puckrin","year":"2025","journal-title":"Eur. J. Haematol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.3324\/haematol.2011.042333","article-title":"Reassessment of small lymphocytic lymphoma in the era of monoclonal B-cell lymphocytosis","volume":"96","author":"Gibson","year":"2011","journal-title":"Haematologica"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1182\/blood-2014-02-556399","article-title":"Development of a comprehensive prognostic index for patients with chronic lymphocytic leukemia","volume":"124","author":"Pflug","year":"2014","journal-title":"Blood"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1001\/jamaoncol.2017.5604","article-title":"Prognostic factors for complete response to ibrutinib in patients with chronic lymphocytic leukemia: A pooled analysis of two clinical trials","volume":"4","author":"Jaglowski","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2516","DOI":"10.1182\/blood.V89.7.2516","article-title":"11q deletions identify a new subset of B-cell chronic lymphocytic leukemia characterized by extensive nodal involvement and inferior prognosis","volume":"89","author":"Stilgenbauer","year":"1997","journal-title":"Blood"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1038\/s41375-024-02267-x","article-title":"ERIC recommendations for TP53 mutation analysis in chronic lymphocytic leukemia\u20142024 update","volume":"38","author":"Malcikova","year":"2024","journal-title":"Leukemia"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/6\/1200\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:35:53Z","timestamp":1782128153000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/6\/1200"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":16,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["medicina62061200"],"URL":"https:\/\/doi.org\/10.3390\/medicina62061200","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]}}}