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Staging CLL

staging of CLL Stage A Stage B and Stage C

Staging means getting an overall picture of the level of disease.

It is important because it allows decisions to be made about the best treatment for CLL.

Recent developments in the treatment of CLL (known as “Novel Therapies”) now mean that patients can move back and forth between stages in some instances.

Binet system

This is used by most European doctors.

It has three stages: A, B and C.

It measures your number of white blood cells, if your glands are enlarged, especially in your neck, armpits, groin, liver or spleen, and if you have anaemia or fewer platelets.

Stage A is a low level of the disease, B is a medium level, while C is a high level.

Stage A – fewer than 3 groups of enlarged lymph nodes (lymphadenopathy) and a high white blood cell count

Stage B – more than 3 groups of enlarged lymph nodes and a high white blood cell count

Stage C – enlarged lymph nodes or spleen, a high white blood cell count, and low red blood cell or platelet counts

In each stage, a group of lymph nodes means lymph nodes in one area of the body, for example, in the neck, underarms or groin.

Each area counts as one group even if the nodes on both sides of the body are swollen. So, you may have swollen lymph nodes under both your arms and this would count as one group.

The spleen also counts as one group of lymph nodes.

In stage A, it is likely the only symptom you may have is enlarged lymph nodes

In stage B, you may feel tired and under the weather, or you may have no symptoms

In stage C, you have low levels of red blood cells (anaemia) and feel tired. You may also have signs of abnormal blood clotting, such as nosebleeds, unexplained bruising or unusually heavy periods. You may be prone to getting repeated infections. You might also lose weight and have night sweats.

Rai system

This is more commonly used in the USA to stage CLL

It has five stages (0 to IV).

It measures the number of white blood cells, if any lymph nodes are enlarged, if the liver or spleen is affected, and if there is an indication of anaemia or fewer platelets. The higher the number, the more advanced the disease.

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