What is staging?
When a person is diagnosed with CLL, a doctor will determine the stage of the condition (how the cancer behaves)4.
This helps a doctor in deciding treatment and predicting prognosis (course/outcome of condition)4. Your doctor will consider several factors in staging your CLL:
- Blood tests (e.g. red blood cell and platelet count)
- Which lymph nodes (e.g. neck, armpit, inner thigh/genital area, spleen, liver) and other parts of the body (e.g. bone marrow) are affected.
For years, the CLL has been classified according to two staging systems: the system proposed by Kanti Rai and the one proposed by Jacques-Louis Bine. Both staging systems define the stage of CLL based on the number of lymph nodes increased in volume, the presence of an increase in the volume of the spleen, liver and observing whether or not a reduction in hemoglobin and/or number of platelets.
Staging of RAI
0= Only lymphocytosis (increased lymphocytes )
I = Lymphocytosis + swollen lymph nodes
II= Lymphocytosis + enlarged spleen and / or liver enlargement [± swollen lymph nodes ]
III = Lymphocytosis + anemia [± enlarged spleen ± ± enlarged liver swollen lymph nodes ] IV= Lymphocytosis + thrombocytopenia (lack of platelets ) [± anemia ± enlarged spleen ± ± enlarged liver swollen lymph nodes ]
Staging of BINET
A= <* 3 nodal areas involved, no anemia or thrombocytopenia
B = 3 * nodal areas involved, no anemia or thrombocytopenia
C =Anemia and / or thrombocytopenia
* 5 different lymph node areas are considered: the cervical, axillary, inguinal, spleen and liver.
Many other clinical and biological parameters were identified which proved valuable in predicting the progression of CLL. Among these factors is the doubling time (the time it takes for the lymphocyte count to double). Currently, the most important information about the progression of CLL is that derived from the biological characteristics of leukemic cells. Some genetic traits have revealed vital data on how the disease will grow, as well as aiding in choosing the most appropriate choice of treatment.