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| __NOTOC__ | | __NOTOC__ |
| {{Chronic lymphocytic leukemia}} | | {{Chronic lymphocytic leukemia}} |
| {{CMG}}; {{AE}} {{RT}} | | {{CMG}} {{AE}}{{HL}} |
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| == Classification == | | ==Overview== |
| | | ===Staging System=== |
| === Clinical staging ===
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| Staging is done with the Rai staging system and the Binet classification (see details<ref name="NCI-CLL-page2">{{cite web |url=http://www.cancer.gov/cancertopics/pdq/treatment/CLL/HealthProfessional/page2 |title=Chronic Lymphocytic Leukemia (PDQ®) Treatment: Stage Information |author=National Cancer Institute |accessdate=2007-09-04 |format= |work=}}</ref>). | |
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| ==== Rai staging system ====
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| {| style="width:80%; height:110px" border="1"
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| | style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Stage 0'''
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| | style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | Absolute lymphocytosis (>15,000/mm3) without adenopathy, hepatosplenomegaly, anemia, or thrombocytopenia.
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| |- bgcolor="LightSteelBlue"
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| | '''Stage 1'''
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| | bgcolor="Beige"| Absolute lymphocytosis with lymphadenopathy without hepatosplenomegaly, anemia, or thrombocytopenia.
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Stage 2'''
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| | bgcolor="Beige"| Absolute lymphocytosis with either hepatomegaly or splenomegaly with or without lymphadenopathy.
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| |- bgcolor="LightSteelBlue"
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| | '''Stage 3'''
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| | bgcolor="Beige"| Absolute lymphocytosis and anemia (hemoglobin <11 g/dL) with or without lymphadenopathy, hepatomegaly, or splenomegaly.
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| |- bgcolor="LightSteelBlue"
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| | '''Stage 4'''
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| | bgcolor="Beige"| Absolute lymphocytosis and thrombocytopenia (<100,000/mm3) with or without lymphadenopathy, hepatomegaly, splenomegaly, or anemia.
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| |}
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| ==== Binet Classification ====
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| {| style="width:80%; height:100px" border="1"
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| | style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Clinical stage A'''
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| | style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No anemia or thrombocytopenia and fewer than three areas of lymphoid involvement (Rai stages 0, I, and II).
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| |- bgcolor="LightSteelBlue"
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| | '''Clinical stage B'''
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| | bgcolor="Beige"| No anemia or thrombocytopenia with three or more areas of lymphoid involvement (Rai stages I and II).
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| |- bgcolor="LightSteelBlue"
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| | '''Clinical stage C'''
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| | bgcolor="Beige"| Anemia and/or thrombocytopenia regardless of the number of areas of lymphoid enlargement (Rai stages III and IV).
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| |}
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| The '''Binet classification''' integrates the number of nodal groups involved with the disease with bone marrow failure. Its major benefit derives from the recognition of a predominantly splenic form of the disease, which may have a better prognosis than in the '''Rai staging''', and from recognition that the presence of anemia or thrombocytopenia has a similar prognosis and does not merit a separate stage. Neither system separates immune from nonimmune causes of cytopenia. Patients with thrombocytopenia or anemia or both, which is caused by extensive marrow infiltration and impaired production (Rai III/IV, Binet C) have a poorer prognosis than patients with immune cytopenias.[4] The International Workshop on CLL has recommended integrating the Rai and Binet systems as follows: A(0), A(I), A(II); B(I), B(II); and C(III), C(IV).
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| == References == | | == References == |