The way a cancer grows is called its pathophysiology. Chronic lymphocytic leukemia (CLL) is the only type of leukemia whose pathophysiology is described in terms of well-defined stages.
In that way, it is staged similarly to cancer of organs, such as breast or lung. The Rai system is the classification system used in the United States. It classifies leukemia into stages 0 through IV. Another system, called the Binet system, classifies leukemia into stages A through C. It is used in some parts of Europe.
Stage 0. In this stage, your blood has too many lymphocytes, called lymphocytosis. You have more than 5,000 to 10,000 lymphocytes per cubic millimeter. You don't have any other signs or symptoms of leukemia. This stage is considered low risk, which means people tend to have longer survival rates and generally have no or few symptoms.
Stage I. In this stage, your blood has too many lymphocytes, called lymphocytosis, and your lymph nodes are larger than normal. This stage is considered intermediate risk.
Stage II. In this stage, your blood has too many lymphocytes, called lymphocytosis, and your liver may be swollen, called hepatomegaly. Or your spleen may be swollen, called splenomegaly . Or they may both be swollen. Your lymph nodes may also be larger than normal. This stage is also considered intermediate risk.
Stage III. In this stage, your blood has too many lymphocytes, called lymphocytosis, and you have too few red blood cells, called anemia. Your lymph nodes, liver, or spleen may also be larger than normal. This stage is considered high risk.
Stage IV. In this stage, your blood has too many lymphocytes and too few platelets, called thrombocytopenia. Your lymph nodes, liver, or spleen may be larger than normal, and you may have too few red blood cells. This stage is considered high risk.
In addition to the stage of your CLL, other factors help predict your outlook for survival. Your doctor may take these factors into account when evaluating your treatment options. Adverse prognostic factors are those that tend to be linked to a shorter survival. Favorable prognostic factors tend to predict a longer survival.
Among other factors, CLL cells that have developed the ability to make antibodies tend to be associated with a more favorable prognosis. Those people with CLL have an average survival of 20 to 25 years. If the CLL cells do not mature and create antibodies, the survival time tends to be shorter, an average of eight to 10 years.
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