Clinical Staging

The Binet and Rai staging systems are useful in predicting median survival in chronic lymphocytic leukaemia (CLL) (Table 2) (Binet et al., 1977; Binet et al., 1981; Rai et al., 1975). For more information on these staging systems please see the section on Diagnosis and Staging. However, these systems are not so useful in patients with early CLL i.e., patients with a low tumour burden who have Binet stage A or Rai stage 0/1 disease (Oscier et al., 2012).

Table 2. Staging systems for CLL (adapted from Oscier et al., 2012; Eichorst et al., 2015)
Please note: These original staging systems are presented alongside more recent outcome data
Binet Stage Features Median survival

A

<3 Lymphoid areas*

>10 years

B

≥3 Lymphoid areas

>8 years

C

Haemoglobin <10 g/dL

or

platelet count <100 x 109/L

6.5 years

Rai Stage / risk group Features  

0 / low risk

Lymphocytosis only

>10 years

I / intermediate risk

Lymphadenopathy

>8 years

II / intermediate risk

Hepatomegaly or splenomegaly
and
lymphocytosis

III / high risk

Lymphocytosis and haemoglobin <11 g/dL
with/without
lymphadenopathy/organomegaly

6.5 years

IV / high risk

Lymphocytosis and platelet count <100 x 109/L
with/without
lymphadenopathy/organomegaly

*The five lymphoid areas comprise: uni or bilateral cervical, axillary and inguinal lymphoid, hepatomegaly and splenomegaly.