The purpose of this protocol is to collect blood, tissue (bone marrow and lymph node biopsies) and/or imaging studies (PET and CT scans) from patients with monoclonal B cell Lymphocytosis (MBL) and chronic lymphocytic leukemia/small lymphoma (CLL/SLL)

Assessments will be used for clinical and translational research investigating the molecular basis of Monoclonal B cell lymphocytosis (MBL) and Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL) and their clinical manifestations. New technologies now permit the simultaneous characterization of pathogenic events ranging from the control of gene expression to the characterization of the molecular events of cell-cell interactions. Applying these methods to MBL/CLL/SLL in the context of a natural history protocol can help unravel cellular pathways involved in pathogenesis and disease progression and lead to the discovery or the validation of therapeutic targets. MBL/CLL/SLL is an incurable disease for which there are no cell lines and only a few mouse models. There is an urgent need to obtain a flow of primary samples to advance research into pathogenesis and novel treatment approaches.

Eligibility:

• Diagnosis of MBL/CLL/SLL
• Age greater than or equal to 18 years.
• Patients must have received no previous cytotoxic or monoclonal antibody therapy for CLL/SLL.
• ECOG performance status of 0-2.

Design:

-Patients will be followed as needed and clinically indicated; typically this will include visits between every 3-12 months. Patients may donate cellular products or tissues as appropriate for research purposes. Clinical information will be obtained and stored in a central databank.

Objectives:

• Describe the natural history of MBL/CLL/SLL in patients prior to the time when their disease requires treatment.
• Apply the expertise and available technologies of the investigators to advance our understanding of disease pathogenesis and develop novel treatment approaches for CLL/SLL.
• Provide evaluation, diagnostic studies and monitoring for patients on study.
• Provide blood and tissue linked to clinical and biologic information for translational studies.

Endpoints:

-Progression free survival, measured as the time from diagnosis to the development of active disease that requires treatment at which tie patients will be able to change to a treatment protocol or seek treatment outside of NIH.