It often progresses slowly and is diagnosed most often during routine blood testing.
Understanding the stages of CLLfrom stage 0 to 4can help you navigate a CLL diagnosis.
The most common staging system in the United States is the Rai system.
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The Binet system is used more frequently in Europe.
Stage 0
Stage 0 is the earliest and most low-risk CLL stage.
Most people diagnosed with CLL will be diagnosed at stage 0.
It is often found incidentally during routine blood tests.
Red blood cells and platelets are at normal or near normal levels.
Lymph nodes may or may not be enlarged as well.
Red blood cell and platelet levels are at normal or near normal levels.
Stage 4
Stage 4 CLL is the most advanced stage of the disease.
It is indicated by a high lymphocyte count, anemia, and a low platelet count.
There may or may not be enlargement of the lymph nodes, spleen, or liver.
As CLL advances into further stages, it becomes more aggressive and may have a poorer prognosis.
However, advancements in research and treatments have improved the outlook for CLL.
The five-year relative survival for CLL in 1975 was 65.1%, but increased to 87.2% by 2021.
At an early stage, there may be no disease symptoms at all.
The development of these symptoms can indicate active disease and may mean that treatment is necessary.
The exact treatment will be decided upon in consultation with an oncologist (cancer specialist).
In stage 0 CLL, treatment isnt usually required.
The primary medical approach is watchful waiting.
Stage 1 CLL is still an early stage.
If you are not experiencing any symptoms, no treatment is required.
Watchful waiting may still be all that is needed.If there are symptoms present, treatment may be started.
Treatment options are listed in the section below.
Stages 2 to 4
As CLL progresses and treatment is required, many treatment options are available.
Treatments may be individualized and based on the presence or absence of genetic mutations in the CLL.
Treatments may be used alone or in various combinations.
These medications tend to have fewer side effects than chemotherapy (which affects all actively dividing cells).
Immunotherapy
Immunotherapyuses the bodys immune system to help fight CLL.
Examples of immunotherapy are Rituxan (rituximab), Gazyva (obinutuzumab), and Arzerra (ofatumumab).
Chemotherapy
Chemotherapy medications kill rapidly dividing cells.
Radiation Therapy
Radiation therapy uses high-energy beams to kill cancer cells.
Clinical Trial
Clinical trialsmay be an option for treatment.
These are studies to evaluate new treatments and combinations of therapies.
Routine testing and follow-up appointments are needed to check for disease progression and evaluate how well treatment is working.
In routine follow-ups, blood tests and imaging may assess the progression of CLL.
These visits also provide a place for discussing symptoms and receiving needed support.
Summary
Chronic lymphocytic leukemia is a slow-growing cancer of the blood and bone marrow.
Understanding the stages of CLL, from 0 to 4, helps determine the best treatment options.
Advanced stages (3 and 4) may need more active treatment.
Regular testing and follow-up appointments are important for monitoring disease progression and treatment effectiveness.
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