Doctors use staging to help them predict the progression of leukemia and develop an appropriate treatment plan. While most cancers are staged based on the size and spread of tumors, leukemia staging is a little bit different because it already occurs in the developing blood cells in the bone marrow. Factors affecting leukemia staging and prognosis include:
Unlike many other cancers that form tumors, CLL is generally in the bone marrow and blood. And, in many cases, has spread to other organs such as the spleen, liver, and lymph nodes by the time it’s found. If you have been diagnosed with CLL, your prognosis will depend on other information, such as the results of lab and imaging tests.
When it comes to staging CLL, there are two primary systems that can be used: the Rai system and the Binet System. Both of these staging systems, which have been in use for many years, are very helpful in determining the severity of your leukemia.
The Rai system is based on lymphocytosis, an increase in the number or proportion of lymphocytes (a type of white blood cell) in the blood that isn’t linked to any other cause, such as an infection.
With this staging system, CLL is broken down into three separate risk groups:
These risk groups are used when the time comes to decide on the best course of treatment.
In the Binet staging system, CLL is classified by the number of affected lymphoid tissue groups (neck lymph nodes, underarm lymph nodes, groin lymph nodes, spleen, and liver) and by whether or not the patient has anemia (too few red blood cells) or thrombocytopenia (too few blood platelets).
There are two main systems that have been used to classify AML into subtypes. They are the French-American-British (FAB) classification and the newer World Health Organization (WHO) classification.
The FAB classification was created in the 1970s by a group of French, American, and British leukemia experts who divided AML into subtypes, M0 through M7, based on the type of cell the leukemia develops from and how mature the cells are. This was based largely on how the leukemia cells looked under the microscope after routine staining.
Subtypes M0 through M5 all start in immature forms of white blood cells. M6 AML starts in very immature forms of red blood cells, while M7 AML starts in immature forms of cells that make platelets.
Unlike the FAB classification system, the WHO classification system takes into account many of the factors that are now known to affect the prognosis (outlook) that can better classify AML.
The WHO system divides AML into several groups, including:
CML is classified into 3 groups that help predict outlook. Rather than being called stages, doctors call these groups phases. The phases are based mainly on the number of immature white blood cells (blasts) in the blood or bone marrow.
There 3 phases of CML are:
Rather than using traditional staging methods, doctors have found that cytogenetic tests, flow cytometry, other lab tests, and factoring in the patient’s age provide more detailed information about the subtype of ALL and the prognosis. These tests help divide ALL into groups based on the gene and chromosome changes in the leukemia cells.
The WHO system divides ALL into several groups, which include:
At Rocky Mountain Cancer Centers (RMCC), we understand that these various stages of leukemia can be both overwhelming and confusing. If you need more clarification regarding the stage of your leukemia, your RMCC oncologist will be happy to explain it to you in a way that you are sure to understand.