The stages of CLL

Staging CLL means describing the extent of the disease. This helps your doctor to plan your treatment, as different stages need different treatments.

There are different ways to stage CLL. The 2 most common are:

The Binet system

The Binet system has three stages: A, B and C. It measures the number of white blood cells and if you have anaemia (low red blood cells) or a reduced number of platelets. The Binet staging system also counts the number of areas in your body where you have enlarged lymph nodes. Lymph nodes are mainly found in the neck, armpits, groin, liver and spleen,

• Stage A: There are fewer than three areas of enlarged lymph nodes
• Stage B: There are three or more areas of enlarged lymph nodes
• Stage C: There are a reduced number of red blood cells, platelets or both.

The Rai system

The Rai system has five stages. The stage is described as 0-4, shown in roman numerals: 0, I, II, III and IV.

Your consultant may use both the Binet and Rai systems, so you will see both a letter and a roman numeral. For example, stage A0 or CIV. 

Your consultant may also use a different system. You don't need to understand all the details. The important thing is to understand what it means for you and your treatment.

Transformation

Occasionally CLL cells can change (transform) into different types of blood cancers (such as Richter's syndrome, a fast-growing cancer of the lymphatic system or prolymphocytic leukaemia – PLL). This is very rare and may occur with a sudden increase in symptoms. For example, fevers, extensive weight loss and swollen glands. If your CLL transforms into a faster-growing cancer, you are more likely to need immediate treatment. You doctor will advise you about your treatment options.