Stages of chronic lymphocytic leukaemia

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

Binet staging system

The Binet staging system 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.

• Stage A There is a high number of white cells in the blood and less than three areas of enlarged lymph nodes.
• Stage B There is a high number of white cells in the blood and three or more areas of enlarged lymph nodes.
• Stage C There is a high number of white cells in the blood and a reduced number of red cells, platelets or both.

Transformation

In a small number of people with CLL (about 5 in 100), the leukaemia can change and start to grow more quickly. This is called transformation. It may change into another type of leukaemia (prolymphocytic leukaemia) or a type of lymphoma| (cancer of the lymphatic system).

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. Symptoms can 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.