Part of the diagnosis process of chronic lymphocytic leukemia (CLL) includes a staging diagnosis to determine the progression of the cancer and the treatment needed. This is done using a variety of tests such as checking for body swelling of lymph system organs, blood tests, imaging, and sometimes bone marrow tests. Your doctor will use either one or a combination of the following staging systems to determine this. The staging systems include the Rai system (most common in the United States) and the Binet system (more commonly used in Europe).

The Rai System

The Rai system is based on lymphocytosis. A high number of lymphocytes must be present in the blood and bone marrow that isn’t a result of any other infection. “For a diagnosis of CLL, the overall lymphocyte count does not have to be high, but the patient must have at least 5,000/mm monoclonal lymphocytes (sometimes called a monoclonal lymphocytosis). Monoclonal means that the cancer cells all came from one original cell. This causes them to have the same chemical pattern which can be seen with special testing” (cancer.org).

Source: NCCN Guidelines for CLL Patients

Source: NCCN Guidelines for CLL Patients

The Binet System

The Binet system classifies CLL based on the number of affected lymphoid tissue groups (neck, groin, underarm, spleen, liver). Anemia (low red blood cells) and thrombocytopenia (low platelet count) are also considered.

• Binet Stage A: fewer than 3 areas of lymphoid tissue are enlarged. Anemia and thrombocytopenia are not present
• Binet Stage B: 3 or more areas of lymphoid tissue are enlarged. Anemia and thrombocytopenia are not present
• Binet Stage C: any number of lymphoid tissues are enlarged. Anemia and/or thrombocytopenia are present

Be active in your CLL care. Once the disease progresses, there are several non-chemo treatment options available that for many CLL patients, successfully help manage the cancer.