Staging CLL

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Oncologists use a standard staging system to assign a number (1-4) or measure to the degree of advancement of a cancer case. Different cancer types have different metrics. In most cancers, stage 4 indicates metastasis has already occurred; in other words the cancer/tumor cells have spread to and affected other tissues away from where they began to grow. Since CLL generally doesn’t form tumors and doesn’t usually metastasize, stage four has a different meaning here. I was stage 4 before I began treatment. RAI staging is more common in the USA. Here is an explanation via the Luekemia & Lymphoma Society.

Doctors use staging to help them predict chronic lymphocytic leukemia’s (CLL’s) progression and develop an appropriate treatment plan. Doctors use one of two staging systems: the Rai staging system or the Binet staging system.
Staging systems consider certain factors such as:

  • the elevation of your blood and marrow leukemic lymphocyte counts
  • your lymph nodes’ size and distribution
  • your spleen’s size
  • the extent of your decreased blood platelet counts
  • the degree of anemia

RAI Staging System

The Rai staging system classifies CLL into the following five stages based on factors at the time of diagnosis:

Low-Risk 0
  • Abnormal increase in the number of lymphocytes in the blood and marrow
Intermediate
Risk I
  • Abnormal increase in the number of lymphocytes in the blood and marrow
  • Enlarged (swollen) lymph nodes
Intermediate
Risk II
  • Abnormal increase in the number of lymphocytes in the blood and marrow
  • Enlarged (swollen) lymph nodes, liver or spleen
High Risk III
  • Abnormal increase in the number of lymphocytes in the blood and marrow
    Low platelet count
  • Abnormal increase in the number of lymphocytes in the blood and marrow
    Low platelet count
High Risk IV
  • Abnormal increase in the number of lymphocytes in the blood and marrow
  • Low platelet count
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