Staging chronic lymphocytic leukemia
Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Cancers that form solid tumours are given numbered stages based on the size of the tumour and if the cancer has spread to lymph nodes or other parts of the body.
Chronic lymphocytic leukemia (CLL) is not staged in the same way as other types of cancer. CLL is a cancer of the white blood cells (lymphocytes). Blood cells, including white blood cells, are formed in the bone marrow throughout the body.
To determine the stage of CLL, the healthcare team will do a physical exam and a blood test called a
- abnormal blood cells in the blood
- enlarged lymph nodes or spleen
- decreased levels of red blood cells or platelets in the blood (which happens when the abnormal white blood cells overcrowding the bone marrow)
Knowing the stage helps your healthcare team understand how CLL will likely affect your body, plan what treatments should start right away and estimate the outcome (prognosis).
Rai staging system
The staging system that is used most often for CLL in Canada is the Rai staging system. It has 5 stages – stage 0 followed by stages 1 to 4. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more advanced the cancer.
Talk to your doctor if you have questions about staging.
Stage 0
The lymphocyte count in the blood is higher than normal (called lymphocytosis) and is at a level to diagnose it as CLL.
The numbers of red blood cells and platelets are normal.
The lymph nodes, spleen and liver are not enlarged.
Stage 1
The lymphocyte count in the blood is higher than normal and meets the level to be diagnosed as CLL.
The numbers of red blood cells and platelets are normal.
Some lymph nodes are enlarged, but the spleen and liver are not enlarged.
Stage 2
The lymphocyte count in the blood is higher than normal and meets the level to be diagnosed as CLL.
The numbers of red blood cells and platelets are normal.
The lymph nodes may or may not be enlarged.
The spleen or the liver is enlarged.
Stage 3
The lymphocyte count is higher in the blood than normal and meets the level to be diagnosed as CLL.
The number of red blood cells in the blood is lower than 110g/L (called anemia).
The number of platelets is normal.
The lymph nodes, spleen or liver may be enlarged.
Stage 4
The lymphocyte count is higher in the blood than normal and meets the level to be diagnosed as CLL.
The number of platelets in the blood is lower than 100 x 109/L (called thrombocytopenia).
The number of red blood cells may be low.
The lymph nodes, spleen or liver may be enlarged.