Stage Zero (Rai Stage 0)
Chronic lymphocytic leukemia, also known as Cll or CLL, attacks the bone marrow of the patient instead of creating a single tumor. Most cancer stages rely on the diameter of a tumor, but Cll must examine the effects the cancer has had on the immune system. Cll affects the rate of white blood cell (lymphocyte) formation as these are made in the bone marrow attacked by the cancer. Patients with milder forms of the cancer live up to 15 more years, but those with the more severe form only survive up to 8 years after diagnosis.
The initial stage of Cll shows the patient with over 10,000 lymphocytes ( cells) per cubic mm, but stage 0 does not show swelling of other portions of the immune system--spleen, liver or lymph nodes. The numbers of red blood cells and platelets remain in normal levels. At this stage, the patient has a low risk.
Patients might not notice anything wrong, but the increased lymphocytes do not function as effectively against fighting infections. Over the course of the development of Cll, these faulty lymphocytes outnumber the healthy white blood cells and the patient has difficulty in fighting illnesses.
Stage I
In stage I of the Rai scale, used in the United States, the same increased number of lymphocytes occurs, but the lymph nodes swell. Other parts of the immune system and blood remain normal. Both stage I and stage II show that the patient has immediate risk for needing treatment.
Stage II
Stage II shows the progression of the cancer by evidence of spread to the spleen and, in some patients, the liver. These organs become enlarged along with the lymph nodes. Normal levels of red blood cells and platelets in the blood show that the patient's risk has not increased to a high for needing treatment evaluation.
Stage III
Stages III and IV mark the high risk time of CLL. Immediate treatment for patients diagnosed at these stages is often given. In addition to the elements of stage II, stage III also shows that the patient has too few red blood cells, resulting in anemia. Platelet counts stay in a normal range.
Stage IV
The patient continues to exhibit increased lymphocyte (white blood cell) counts over 10,000 per cubic mm. Additionally, this last stage has low numbers of platelets in the blood and significant swelling of the lymph nodes, spleen and liver. Like in stage III, the patient does not have enough red blood cells, causing anemia. Since doctors consider patients in stages III and IV at high risk, treatment begins with diagnosis.
Treatment Options for CLL
Should the patient receive a diagnosis of Cll in stage III or IV, treatment likely will begin immediately, but a doctor might watch a patient carefully in stage I and stage II before offering treatment. These options could be given to a patient at any stage of Cll. A doctor evaluates the patient for treatment options which might include stem cell transplants, radiation therapy or combination drug therapies.
Tags: blood cells, lymph nodes, white blood, that patient, blood cell, blood cells platelets, bone marrow