Stages of chronic lymphocytic leukaemia (CLL)
Staging for CLL helps doctors to know when you may need treatment, and which treatment would be best for your situation. Find out about the stages of CLL.
What is staging for chronic lymphocytic leukaemia (CLL)?
Chronic lymphocytic leukaemia (CLL) and small lymphocytic lymphoma (SLL) are treated as different forms of the same blood cancer. In this information, we use the term CLL to refer to both types.
Staging describes how much chronic lymphocytic leukaemia there is in the body. This helps your cancer team know how advanced the CLL is. They use this and information about any symptoms you have, to help them plan the right treatment for you.
There are 2 staging systems used for CLL:
- the Binet system
- the Rai system.
The Binet system is most commonly used in the UK.
We understand that waiting to know the stage of your cancer can be a worrying time. We are here if you need someone to talk to. You can:
- call the Macmillan Support Line for free on 0808 808 00 00
- chat to our cancer information specialists online
- visit our Online Community to connect with people who have been affected by CLL, share your experience, and ask questions.
Binet staging system
This looks at the number of white blood cells, red blood cells and platelets in the blood. It also looks 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 enlarged, it is only counted as one area.
There are 3 stages in the Binet system:
CLL transformation
Normally, CLL is a slow growing type of blood cancer. But in some people, it can transform into a faster growing type.
It usually transforms into a type of non-Hodgkin lymphoma (NHL) called diffuse large B-cell lymphoma (DLBCL). But it can sometimes transform into other types of lymphoma, such as Hodgkin lymphoma (HL).
When CLL transforms into DLBCL, it is known as Richter’s transformation.
Richter’s transformation can cause more severe symptoms, such as:
- a sudden swelling of affected lymph nodes, especially in the tummy (abdomen)
- heavy sweats at night
- weight loss
- high temperatures (fever) with no obvious cause.
There may be other reasons for these symptoms. But always tell your doctor if you notice any of them.
Doctors can diagnose transformation of CLL with a bone marrow biopsy, a lymph node biopsy and blood tests.
Depending on your situation, treatments for Richter’s transformation usually involve more intensive cancer drug treatments.
It is important to remember that transformation is unusual and does not happen for most people with CLL.
Related pages
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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ReferencesBelow is a sample of the sources used in our chronic lymphocytic leukaemia (CLL) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Eichhorst B, et al. Robak T, Montserrat E, et al. Chronic Lymphocytic Leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up. Annals of Oncology. Published online October 19 2020 32(1) 23-33. Available from: www.doi.org/10.1016/j.annonc.2020.09.019 [accessed 2023].
Walewska R, Eyre T.A, Bloor A et al. Guideline for the treament of chronic lymphocytic leukaemia. British Society for Haematology 2025. Br J Haematology Vol 207 (6) 2296-2313. Available from: www.doi.org/10.1111/bjh.70100 [accessed August 2026].
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