Several of the epidemiological studies aimed at identifying risk factors for CLL/SLL occurrence, but no acquired causative factors leading to CLL development have been identified so far. Genetic alterations, BCR and B cell signaling pathway, cancer microenvironment and Immune deficiency contribute to disease susceptibility. Chronic lymphocytic leukemia has one of the strongest inherited predispositions of haematological malignancies. About 10% of individuals who develop chronic lymphocytic leukemia have a family history of the disease.

Early on there are typically no symptoms. Later non-painful lymph nodes swelling, feeling tired, fever, or weight loss for no clear reason may occur. Enlargement of the spleen and anemia may also occur². It typically worsens gradually.

International guidelines clearly specify that treatment indication is based on the presence of active disease. Patients with an established diagnosis of chronic lymphocytic leukaemia should undergo risk stratification^1,2. The treatment choice requires a careful evaluation of different factors including: patient fitness status, the genetic profile and the disease status. The treatment of CLL including novel target therapy (e.g. BTK inhibitors, etc), Chemo-immunotherapy, Stem cell transplantation,etc^1,2.
  

1.  Hematology Committee of Chinese Medical Association; Hematological Oncology Committee of China Anti-Cancer Association; Chinese Working Group for Chronic Lymphocytic Leukemia. The guidelines for diagnosis and treatment of chronic lymphocytic leukemia/small lymphocytic lymphoma in China (2018 edition). Zhonghua Xue Ye Xue Za Zhi, 2018 ,39(5):353-358.
2.  NCCN.The NCCN guidelines for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma(version 3.2019)[EB/OL].Fort Washington:NCCN,2019. https://www.nccn.org/professionals/physician_gls/pdf/cll.pdf.