Chronic lymphocytic leukemia clinical staging: Difference between revisions
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==Staging System== | ==Staging System== | ||
===Rai 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, [[platelet]]s level, presence of [[splenomegaly]], and presence of [[lymphadenopathy]].<ref name="pmid11390392">{{cite journal |vauthors=Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS |title=Clinical staging of chronic lymphocytic leukemia |journal=Blood |volume=46 |issue=2 |pages=219–34 |date=August 1975 |pmid=1139039 |doi= |url=}}</ref> | According to the Rai Staging System, there are five stages of chronic lymphocytic leukemia based on the degree of [[lymphocytosis]], [[hemoglobin]] level, [[platelet]]s level, presence of [[splenomegaly]], and presence of [[lymphadenopathy]].<ref name="pmid11390392">{{cite journal |vauthors=Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS |title=Clinical staging of chronic lymphocytic leukemia |journal=Blood |volume=46 |issue=2 |pages=219–34 |date=August 1975 |pmid=1139039 |doi= |url=}}</ref><ref name="pmid3357070">{{cite journal |vauthors=MacDougall BK, Weinerman BH |title=Staging and prognosis of chronic lymphocytic leukemia: the Manitoba experience |journal=J Gen Intern Med |volume=3 |issue=2 |pages=139–43 |date=1988 |pmid=3357070 |doi= |url=}}</ref> | ||
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===Binet Staging System=== | ===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 lymphoid regions: Cervical, axiallry and inguinal lymph nodes; and spleen and liver.<ref name="pmid7237385">{{cite journal |vauthors=Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, Goasguen J, Vaugier G, Potron G, Colona P, Oberling F, Thomas M, Tchernia G, Jacquillat C, Boivin P, Lesty C, Duault MT, Monconduit M, Belabbes S, Gremy F |title=A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis |journal=Cancer |volume=48 |issue=1 |pages=198–206 |date=July 1981 |pmid=7237385 |doi= |url=}}</ref> | 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 lymphoid regions: Cervical, axiallry and inguinal lymph nodes; and spleen and liver.<ref name="pmid7237385">{{cite journal |vauthors=Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, Goasguen J, Vaugier G, Potron G, Colona P, Oberling F, Thomas M, Tchernia G, Jacquillat C, Boivin P, Lesty C, Duault MT, Monconduit M, Belabbes S, Gremy F |title=A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis |journal=Cancer |volume=48 |issue=1 |pages=198–206 |date=July 1981 |pmid=7237385 |doi= |url=}}</ref><ref name="pmid33570702">{{cite journal |vauthors=MacDougall BK, Weinerman BH |title=Staging and prognosis of chronic lymphocytic leukemia: the Manitoba experience |journal=J Gen Intern Med |volume=3 |issue=2 |pages=139–43 |date=1988 |pmid=3357070 |doi= |url=}}</ref> | ||
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Revision as of 00:12, 7 February 2019
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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. 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 lymphoid regions. The tumor stage is considered one of the important factors that determine the optimal management protocol of chronic lymphocytic leukemia patients.
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][2]
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 |
The staging is further modified into 3 groups:[3]
- Low Risk: Stage 0
- Intermediate Risk: Stages 1 and 2 combined
- High Risk: Stage 3 and 4 combined
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 lymphoid regions: Cervical, axiallry and inguinal lymph nodes; and spleen and liver.[4][5]
Stage | Lymphocytosis | Anemia or Thrombocytopenia | Lymphadenopathy | Median Survival |
---|---|---|---|---|
Stage A |
Present |
Absent |
2 or less lymphoid regions |
Almost normal age and sex adjusted survival rate |
Stage B |
Present |
Absent |
>3 lymphoid regions |
7 years |
Stage C |
Present |
Present |
>3 lymphoid regions |
2 years |
References
- ↑ Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS (August 1975). "Clinical staging of chronic lymphocytic leukemia". Blood. 46 (2): 219–34. PMID 1139039.
- ↑ MacDougall BK, Weinerman BH (1988). "Staging and prognosis of chronic lymphocytic leukemia: the Manitoba experience". J Gen Intern Med. 3 (2): 139–43. PMID 3357070.
- ↑ Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating MJ, Montserrat E, Rai KR, Kipps TJ (June 2008). "Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines". Blood. 111 (12): 5446–56. doi:10.1182/blood-2007-06-093906. PMC 2972576. PMID 18216293.
- ↑ Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, Goasguen J, Vaugier G, Potron G, Colona P, Oberling F, Thomas M, Tchernia G, Jacquillat C, Boivin P, Lesty C, Duault MT, Monconduit M, Belabbes S, Gremy F (July 1981). "A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis". Cancer. 48 (1): 198–206. PMID 7237385.
- ↑ MacDougall BK, Weinerman BH (1988). "Staging and prognosis of chronic lymphocytic leukemia: the Manitoba experience". J Gen Intern Med. 3 (2): 139–43. PMID 3357070.