@loriskt. Staging of CLL/SLL is interesting, but doesn't really drive treatment. It's not like most cancers. I was diagnosed at Stage 1 and started treatment at Stage 1 for "progressive Lymphadenopathy ". In other words rapidly growing lymph nodes which were evidence of accelerated disease. My disease is almost exclusively in my nodes as my blood ALC has been normal since diagnosis. In fact my ALC was 1.77 when I started treatment. Your comment that you doctor mentioned Rituximab tells me they are not a true CLL specialist. Rituximab is a anti-cd20 antibody that has been proven inferior to Obinituzimab which is now far more widely used by specialists. There are also multiple targeted drugs that are very effective. I'm currently enrolled in a Mayo clinical trial which is working beautifully.

My personal recommendation is that all CLL/SLL patients should consult a true specialist and go to a major academic cancer center (Mayo, MD Anderson, MSK, Dana Farber, City of Hope, OSU, Weill Cornell, Fred Hutch, etc). I see my specialist every 90 days and travel from Atlanta to Rochester, MN to see her. I also have a local Hematologist, but he is more of an emergency backup. He readily admits CLL is not his specialty.

If you go to the CLL Society website and look under resources you'll find a link of CLL doctors. If yours isn't on the list they aren't an expert and you deserve an expert. My 1st Oncologist wasn't an expert and everything he said was wrong. A bit scary when you think of it.