Chronic lymphocytic leukemia clinical staging
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
According to the Rai Staging System, there are five stages of chronic lymphocytic leukemia based on the degree of lymphocytosis, hemoglobin level, platelets level, presence of splenomegaly, and presence of lymphadenopathy.[1] While according to the Binet Staging System, there are three stages of chronic lymphocytic leukemia based on the degree of lymphocytosis, the presence of anemia or thrombocytopenia, and the involvement of three or more lymph node regions.[2] The tumor stage is considered one of the important factors that determine the optimal management protocol of chronic lymphocytic leukemia patients.[3]
Staging System
Rai Staging System
According to the Rai Staging System, there are five stages of chronic lymphocytic leukemia based on the degree of lymphocytosis, hemoglobin level, platelets level, presence of splenomegaly, and presence of lymphadenopathy.[1]
Stage | Hemoglobin Level | Platelets Level | Lymphocytosis | Splenomegaly | Lymphadenopathy | Median Survival |
---|---|---|---|---|---|---|
Stage 0 |
>11 g/dL |
>100,000/L |
Present |
Absent |
Absent |
>150 months |
Stage 1 |
>11 g/dL |
>100,000/L |
Present |
Absent |
Present |
101 months |
Stage 2 |
>11 g/dL |
>100,000/L |
Present |
Present |
Present or absent |
71 months |
Stage 3 |
<11 g/dL |
>100,000/L |
Present |
Present or absent |
Present or absent |
19 months |
Stage 4 |
<11 g/dL or >11g/dL |
<100,000/L |
Present |
Present or absent |
Present or absent |
19 months |
Binet Staging System
According to the Binet Staging System, there are three stages of chronic lymphocytic leukemia based on the degree of lymphocytosis, the presence of anemia or thrombocytopenia, and the involvement of three or more lymph node regions.[2]
Stage | Lymphocytosis | Anemia or Thrombocytopenia | Lymphadenopathy | Median Survival |
---|---|---|---|---|
Stage A |
Present |
Absent |
Absent |
Almost normal age and sex adjusted survival rate |
Stage B |
Present |
Absent |
Present |
7 years |
Stage C |
Present |
Present |
Present or Absent |
2 years |
References
- ↑ 1.0 1.1 Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS (1975). "Clinical staging of chronic lymphocytic leukemia". Blood. 46 (2): 219–34. PMID 1139039.
- ↑ 2.0 2.1 Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, Goasguen J; et al. (1981). "A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis". Cancer. 48 (1): 198–206. PMID 7237385.
- ↑ Nabhan C, Rosen ST (2014) Chronic lymphocytic leukemia: a clinical review. JAMA 312 (21):2265-76. DOI:10.1001/jama.2014.14553 PMID: 25461996