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For most cancers, staging is the process of finding out how far the cancer has spread. A stage is usually assigned based on the size of the tumor and how far it has spread. This system generally does not apply to leukemia because leukemia does not usually form a solid mass or tumor.

Also, leukemia affects bone marrow and, in many cases, it has already spread to other organs in the body when it is found. For chronic lymphocytic leukemia (CLL), lab tests focus on giving a clear description of different features of the disease. These features, in turn, help predict the likely outcome for the patient and help to guide treatment decisions.

Staging systems

There are 2 different systems for staging CLL. Stages are often useful because they can help guide treatment and predict a person's outlook (prognosis).

  • Rai system: This is used more often in the United States.
  • Binet system: This is used more widely in Europe.

Rai staging system

In the Rai system there are 5 stages from 0 to IV (0 to 4). Then, doctors divide the Rai stages into 3 risk groups when choosing treatment options:

  • Stage 0 is labeled low risk.
  • Stages I and II are intermediate risk.
  • Stages III and IV are called high risk.

Binet staging system

In the Binet staging system, CLL is classified by the number of affected lymphoid tissue groups (neck lymph nodes, groin lymph nodes, underarm lymph nodes, spleen, and liver) and by whether or not the patient has too few red blood cells (anemia) or too few blood platelets (thrombocytopenia). The Binet stages are the letters A (the lowest), B, and C.

Prognostic factors

Other factors besides the stage can help predict a patient's outlook. These factors are called prognostic factors. Factors that are linked to shorter survival time are called adverse prognostic factors. Those linked to longer survival are favorable prognostic factors.

Some of these are based on certain genetic changes or proteins on the CLL cells. Others are just based on the age and sex of the patient. Your doctor can tell you if any of these factors apply to you and what they mean.

Last Medical Review: 01/30/2015
Last Revised: 02/23/2016