Stages
Clinical staging systems have been developed that classify patients based on their risk profile at presentation. The two most common are those developed by Rai and colleagues (1975), which is commonly used in the USA, and Binet and colleagues (1981), which is more often used in Europe. Both systems can be performed using physical examination and standard laboratory tests and both assign patients to one of three risk groups.
Clinical staging remains the gold standard system for deciding when to treat a patient with CLL. For example, patients with Rai stage 0–II or Binet stage A or B and no symptoms are often monitored on a ‘watch-and-wait’ basis with no active treatment until their disease progresses. However, despite the clinical importance of staging, even the ‘low risk’ group of patients is heterogeneous with some cases progressing quickly, and consequently there have been many efforts to identify other prognostic factors.
References
- Rai KR, Sawitsky A, Cronkite EP, et al. Blood 1975;46:219–234.
- Binet JL, Auquier A, Dighiero G, et al. Cancer 1981;48:198–206.
