Staging chronic lymphocytic leukaemia (CLL)
When your doctors have all your test results, they know how far your chronic lymphocytic leukaemia (CLL) has developed. This is called staging.
There are 2 staging systems for CLL:
- Binet staging system
- Rai staging system
Doctors use the Binet staging system in the UK. This has 3 stages of CLL - stages A, B and C.
The Rai system is more common in America. This has 5 stages of CLL - stage 0 to stage 4.
Your doctor uses the stage of your CLL to help them work out whether you need treatment, and if so, what treatment you will need.
How do doctors work out your stage?
Your doctor will examine you and do some tests. When they have all your test results they will know the stage of your CLL.
For Binet staging, doctors look at:
- the number of red blood cells and platelets in your blood
- how many areas of swollen (enlarged)
lymph nodes 
you have
The areas of lymph nodes are in your neck, armpit, groin, spleen and liver. Each area counts as one group even if the nodes on both sides of the body are swollen. So if you have swollen lymph nodes under both your arms, this would count as one group.
The also counts as one group of lymph nodes.
For Rai staging, doctors also look at the number of lymphocytes in your blood. Lymphocytes are a type of white blood cell. A higher than normal number of lymphocytes is called lymphocytosis.
Staging chronic lymphocytic leukaemia (CLL)
The Binet staging system
The Binet staging system for CLL has 3 stages:
- stage A – you have fewer than 3 groups of swollen (enlarged) lymph nodes
- stage B – you have 3 or more groups of enlarged lymph nodes
- stage C – you have a low number of red blood cells or platelets
The symptoms you might feel include:
- stage A, the only symptom you are likely to have is enlarged lymph nodes
- stage B, you may feel tired and under the weather, or you may have no symptoms
- stage C, you have low levels of red blood cells (anaemia) and feel tired. You might have signs of abnormal blood clotting, such as nosebleeds, bruising or heavy periods. You may get repeated infections. You might also lose weight and have night sweats
The Rai staging system
The Rai system has 5 stages:
- stage 0 - you have a high number of lymphocytes
- stage 1 - you have a high number of lymphocytes and enlarged lymph nodes
- stage 2 - you have a high number of lymphocytes and an enlarged liver or spleen. You might also have enlarged lymph nodes
- stage 3 - you have a high number of lymphocytes and a low number of red blood cells. You might also have an enlarged liver or spleen, or enlarged lymph nodes
- stage 4 - you have a high number of lymphocytes and a low number of platelets. You might also have an enlarged liver or spleen, or enlarged lymph nodes
Treatment options for CLL
A team of health professionals decides if you need treatment straight away. They also decide what treatment options you have. The team use your CLL stage to help them with these decisions.
