Leukimia: Stadiums
There are two staging systems that integrate data on the tumor mass but do not predict the possibility of progression.
These two systems are the Binet, used more in Europe, and Rai, which is used in United States.
Rai stages are divided into categories of low risk, intermediate and high. Stage 0 is considered low risk, steps 1 and 2 intermediate risk, 3 and 4 and as high risks.
The Rai system recognizes five stages:
- Stage 0 lymphocytosis: the number of lymphocytes in blood is high (lymphocytosis), about 15,000 per ml.
- Stage I: there is lymphocytosis and lymphadenopathy (lymph nodes are swollen).
- Stage II: lymphocytosis and there is hepatomegaly or splenomegaly (liver or spleen are swollen). There may be no or lymphadenopathy.
- Stage III: lymphocytosis, and anemia (too few red blood cells). Or there may be no hepatomegaly, splenomegaly or lymphadenopathy.
- Stage IV: lymphocytosis, and thrombocytopenia (decreased number of platelets).
The Binet classification system is based on the number of affected lymph nodes (cervical lymph nodes, axillary or inguinal, liver and spleen) and if there is presence or absence of anemia or thrombocytopenia.
- Stage A: Fewer than three lymph nodes increased in size. No anemia or thrombocytopenia.
- Stage B: Three or more lymph nodes involved. No anemia or thrombocytopenia.
- Stage C: anemia and thrombocytopenia.
There are a number of prognostic factors that are not included in the staging systems that are:
- Old age.
- Poor condition.
- Male.
- Effect of bone marrow with a diffuse pattern (indicating a more extensive replacement of normal marrow by leukemic cells).
- Changes in the abnormal chromosomes.
- High blood levels of certain substances, such as Beta-2
- Microglobulin
- Increased proportion of large or atypical lymphocytes in blood samples.
- Speed doubling the number of lymphocytes.
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