Clinical Staging of Chronic Lymphocytic Leukemia

• Published in: Blood Vol. 46; no. 2; pp. 219 - 234
• Main Authors: Rai, Kanti R., Sawitsky, Arthur, Cronkite, Eugene P., Chanana, Arjun D., Levy, Robert N., Pasternack, Bernard S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.1975
• Subjects: Adrenal Cortex Hormones - therapeutic use; Age Factors; Aged; Anemia - etiology; Anemia - pathology; Blood Cell Count; Bone Marrow Examination; Chlorambucil - therapeutic use; Female; Hematocrit; Hepatomegaly - etiology; Hepatomegaly - pathology; Humans; Leukemia, Lymphoid - complications; Leukemia, Lymphoid - pathology; Leukemia, Lymphoid - therapy; Lymph Nodes - pathology; Lymphocytosis - pathology; Male; Middle Aged; Prognosis; Retrospective Studies; Sex Factors; Splenomegaly - etiology; Splenomegaly - pathology; Statistics as Topic; Thrombocytopenia - diagnosis; Thrombocytopenia - etiology
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V46.2.219.219

A method of clinical staging of chronic lymphocytic leukemia (CLL) has been proposed which is based on the concept that CLL is a disease of progressive accumulation of nonfunctioning lymphocytes: stage 0, bone marrow and blood lymphocytosis only; stage I, lymphocytosis with enlarged nodes; stage II, lymphocytosis with enlarged spleen or liver or both; stage III, lymphocytosis with anemia; and stage IV: lymphocytosis with thrombocytopenia. Analysis of 125 patients in the present series showed the following median survival times (in months) from diagnosis: stage 0, > 150; stage I, 101; stage II, 71; stage III, 19; stage IV, 19. The median survival for the entire series was 71 mo. The prognostic significance of the stage remained even after adjustment was made for age and sex. However, both sex and age were shown to be poor predictors of survival after adjustment for stage. The method of staging proved to be a reliable predictor of survival whether used at diagnosis or during the course of the disease. The proposed staging system was an equally accurate indicator for survival when applied to two other previously published studies of large series of patients.