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Detailed mathematical modeling with a deep look at the fingerprints or more precisely next generation DNA sequencing of our cancer cells suggest that our disease started with a very tiny mutant population that grew into a detectable cancer. Other minor cancerous clones may also be present from the very start and subclones can also arise from the mother clone, but CLL is not the usual heterogeneous mix of lymphocytes found in healthy patients. It is a clonal collection of malignant cells that has expanded to above the 5,000 per microliter diagnostic threshold.
Originally published in The CLL Tribune Q3 2015