Stages of Chronic Lymphocytic Leukemia

Staging is the procedure of determining where the tumour is located, whether it has spread or not, and how it grows. While assessing the cancer stage, many factors are taken into account.

Doctors use diagnostic tests to discover cancer’s stage, so staging may not be complete until all tests are finished. 

Rai staging system

CLL is divided into five stages in the Rai staging system, from 0 to IV. This staging system classifies leukaemia Depending on whether a patient has, or doesn’t have, any of the following-

  • Lymphadenopathy, which means a patient has enlarged lymph nodes
  • Lymphocytosis, meaning there are high levels of lymphocytes in the blood
  • Anaemia, which means low levels of red blood cells
  • Hepatomegaly, which is an enlarged liver
  • Splenomegaly, which is an enlarged spleen
  • Thrombocytopenia, meaning low levels of platelets

Rai stage grouping

Stage 0 – The patient has lymphocytosis with more than 5000 lymphocytes per microliter of blood but no other physical signs.

Stage I – The patient has lymphocytosis and enlarged lymph nodes. The patient does not have an enlarged liver or spleen, anaemia, or low levels of platelets.

Stage II – The patient has lymphocytosis and an enlarged spleen or liver and may or may not have swollen lymph nodes.

Stage III – The patient has lymphocytosis and anaemia. The patient may or may not have swollen lymph nodes and an enlarged spleen or liver.

Stage IV – The patient has lymphocytosis and low counts of platelets. The patient may or may not have an enlarged liver or spleen, swollen lymph nodes, or anaemia.

Staging is the procedure of determining where the tumour is located, whether it has spread or not, and how it grows. While assessing the cancer stage, many factors are taken into account.

Doctors use diagnostic tests to discover cancer’s stage, so staging may not be complete until all tests are finished. 

 

Rai staging system

CLL is divided into five stages in the Rai staging system, from 0 to IV. This staging system classifies leukaemia Depending on whether a patient has, or doesn’t have, any of the following-

  • Lymphadenopathy, which means a patient has enlarged lymph nodes
  • Lymphocytosis, meaning there are high levels of lymphocytes in the blood
  • Anaemia, which means low levels of red blood cells
  • Hepatomegaly, which is an enlarged liver
  • Splenomegaly, which is an enlarged spleen
  • Thrombocytopenia, meaning low levels of platelets

Rai stage grouping

Stage 0 – The patient has lymphocytosis with more than 5000 lymphocytes per microliter of blood but no other physical signs.

Stage I – The patient has lymphocytosis and enlarged lymph nodes. The patient does not have an enlarged liver or spleen, anaemia, or low levels of platelets.

Stage II – The patient has lymphocytosis and an enlarged spleen or liver and may or may not have swollen lymph nodes.

Stage III – The patient has lymphocytosis and anaemia. The patient may or may not have swollen lymph nodes and an enlarged spleen or liver.

Stage IV – The patient has lymphocytosis and low counts of platelets. The patient may or may not have an enlarged liver or spleen, swollen lymph nodes, or anaemia.

This chart summarizes the Rai stages.

Rai StageStage 0
High levels of lymphocytesYes
Enlarged lymph nodesNo
Enlarged spleen or liverNo
AnemiaNo
Low levels of plateletsNo
Rai StageStage 1
High levels of lymphocytesYes
Enlarged lymph nodesYes
Enlarged spleen or liverNo
AnemiaNo
Low levels of plateletsNo
Rai StageStage 2
High levels of lymphocytesYes
Enlarged lymph nodesYes or no
Enlarged spleen or liverYes
AnemiaNo
Low levels of plateletsNo
Rai StageStage 3
High levels of lymphocytesYes
Enlarged lymph nodesYes or no
Enlarged spleen or liverYes or no
AnemiaYes
Low levels of plateletsNo
Rai StageStage 4
High levels of lymphocytesYes
Enlarged lymph nodesYes or no
Enlarged spleen or liverYes or no
AnemiaYes or no
Low levels of plateletsyes

Rai stage risk groups

Sometimes, the phrase “risk group” indicates the disease’s likelihood to worsen and require treatment.

Low risk: Rai stage 0

Intermediate risk: Rai stages I and II

High risk: Rai stages III and IV

Binet classification

European doctors use a different staging system, depending on whether the CLL is found in the lymph nodes in the neck, in the groin area or under the arms and whether the patient has low counts of red blood cells or platelets. The stages are called A, B, and C.

Stage A: The patient doesn’t have anaemia or low levels of platelets. Leukaemia can be felt in fewer than three areas of lymph nodes (Rai stages 0, I and II).

Number of enlarged lymph nodes – Less than 3

Stage B: The patient does not have anaemia or low levels of platelets. Leukaemia is in 3 or more areas of lymph nodes (Rai stages I and II).

Number of enlarged lymph nodes – 3 or more

Stage C: The patient has anaemia or low levels of platelets. Leukaemia is in many lymph nodes (Rai stages III and IV).

Number of enlarged lymph nodes – Any number