Staging chronic lymphocytic leukaemia (CLL)

When your doctors have all your test results, they know how far your chronic lymphocytic leukaemia (CLL) has developed. This is called staging.

There are 2 staging systems for CLL:

  • Binet staging system
  • Rai staging system

Doctors use the Binet staging system in the UK. This has 3 stages of CLL - stages A, B and C. 

The Rai system is more common in America. This has 5 stages of CLL -  stage 0 to stage 4.

Your doctor uses the stage of your CLL to help them work out whether you need treatment, and if so, what treatment you will need. 

How do doctors work out your stage?

Your doctor will examine you and do some tests. When they have all your test results they will know the stage of your CLL.

For Binet staging, doctors look at:

  • the number of red blood cells and platelets in your blood
  • how many areas of swollen (enlarged) lymph nodes Open a glossary item you have

The areas of lymph nodes are in your neck, armpit, groin, spleen and liver. If you have enlarged lymph nodes under both arms, this still counts as only one area. So if you have swollen lymph nodes under both your arms, this would count as one group. The spleen Open a glossary item also counts as one group of lymph nodes.

For Rai staging, doctors also look at the number of lymphocytes in your blood. Lymphocytes are a type of white blood cell. A higher than normal number of lymphocytes is called lymphocytosis. 

Staging chronic lymphocytic leukaemia (CLL)

The Binet staging system

The Binet staging system for CLL has 3 stages:

  • stage A – you have fewer than 3 groups of swollen (enlarged) lymph nodes
  • stage B – you have 3 or more groups of enlarged lymph nodes
  • stage C – you have a low number of red blood cells or platelets

The symptoms you might feel include:

  • stage A, the only symptom you are likely to have is enlarged lymph nodes
  • stage B, you may feel tired and under the weather, or you may have no symptoms
  • stage C, you have low levels of red blood cells (anaemia) and feel tired. You might have signs of abnormal blood clotting, such as nosebleeds, bruising or heavy periods. You may get repeated infections. You might also lose weight and have night sweats

The Rai staging system

The Rai system has 5 stages:

  • stage 0 - you have a high number of lymphocytes
  • stage 1 - you have a high number of lymphocytes and enlarged lymph nodes
  • stage 2 - you have a high number of lymphocytes and an enlarged liver or spleen. You might also have enlarged lymph nodes
  • stage 3 - you have a high number of lymphocytes and a low number of red blood cells. You might also have an enlarged liver or spleen, or enlarged lymph nodes
  • stage 4 - you have a high number of lymphocytes and a low number of platelets. You might also have an enlarged liver or spleen, or enlarged lymph nodes
Last reviewed: 
17 Sep 2021
Next review due: 
17 Sep 2024
  • Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    B Eichorst and others.
    Annals of Oncology, 2021, Volume 32 Issue 1 pages 22-33

  • Principles and practice of oncology (10th edition)
    VT De Vita, S Hellman and SA Rosenberg
    Lippincott, Williams and Wilkins, 2015