Stages of chronic lymphocytic leukaemia

There are two staging systems commonly used for CLL: the Binet system and the Rai system. The Binet system is the one most commonly used in the UK.

Binet staging system

This looks at the number of white cells, red cells and platelets in the blood and at how many areas of lymph nodes are enlarged. These areas are in the neck, armpits, groin, liver and spleen. If the lymph nodes in both armpits are swollen this is only counted as one area.

There are three stages in the Binet system:

• 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.

Transformation

In a small number of people with CLL, the leukaemia can change and start to grow more quickly. This is called transformation.

In about 1 in 10 people, CLL may change into another type of leukaemia (prolymphocytic leukaemia). In less than 1 in 10 people, CLL may develop into a particular type of lymphoma| (cancer of the lymphatic system) known as Richter’s syndrome.

Transformation can be found by a blood test that shows a high number of leukaemia cells.

Sometimes, the first sign of transformation is an increase in symptoms. These include a high temperature (fever), sweats and weight loss, and a sudden swelling of affected lymph nodes, especially in the tummy (abdomen). However, symptoms such as a high temperature and weight loss can occur for many other reasons.

It’s important to remember that transformation is unusual and doesn’t happen for most people with CLL.