Stages of Leukemia

Identifying the stages of leukemia can provide important information about the progression of the condition that can help physicians determine the most appropriate treatments. Leukemia cells develop within the bone marrow and do not form masses or tumors, but instead affect the quantities of white blood cells, red blood cells and platelets within the body. Therefore, while most types of cancer are staged based on the size and spread of a primary tumor, the stages of leukemia are determined differently based on blood cell counts and the accumulation of leukemia cells within organs, such as the liver and spleen.

Rather than using traditional methods, such as the TNM staging system, to assign the stages of leukemia, a physician will first determine the subtype of the condition by evaluating the results of cytologic (cellular) tests, flow cytometry or other lab tests. Each leukemia subtype is then staged using a unique system:

  • Acute lymphocytic leukemia – Staged based on the type of lymphocyte and the maturity of the cells
  • Acute myelogenous leukemia – Staged using the French-American-British (FAB) system, which takes into account the number of healthy blood cells, the size and number of the leukemia cells, the changes in the chromosomes of the leukemia cells and other genetic abnormalities
  • Chronic lymphocytic leukemia – Staged using the Rai system, which considers three main factors: the number of lymphocytes in the blood; the degree of lymph node, spleen or liver enlargement and the presence of anemia or thrombocytopenia
  • Chronic myelogenous leukemia – Staged based on the number of diseased cells found in blood and bone marrow tests

The stages of leukemia relate generally to a patient’s prognosis, mainly in that patients who are diagnosed in early stages tend to have better outcomes. Nevertheless, the stage of the condition alone cannot predict a patient’s outcome with any degree of certainty, and furthermore, there is a wide range of outcomes for patients with the same stage of leukemia.

Stages of chronic leukemia

The Rai system is used to stage chronic leukemia:

  • Stage 0 – A patient has high levels of white blood cells, but no other physical symptoms.
  • Stage 1 – A patient has high levels of white blood cells and enlarged lymph nodes.
  • Stage 2 – A patient has high levels of white blood cells and is anemic. He or she may also have enlarged lymph nodes.
  • Stage 3 – A patient has high levels of white blood cells and is anemic. He or she may also have enlarged lymph nodes and/or an enlarged liver or spleen.
  • Stage 4 – A patient has high levels of white blood cells and low platelets. He or she may also be anemic, have enlarged lymph nodes and have an enlarged liver or spleen.

Is leukemia curable?

Leukemia cannot be cured, but it can be prevented from coming back in the future. It all depends on the treatment. Most commonly, leukemia patients are treated using a combination of chemotherapy, radiation therapy, stem cell transplants and antibiotics. 

The five-year survival rate for all types of leukemia is around 61%, with the survival rate being higher for people under age 55 than for older individuals.

Moffitt Cancer Center’s approach to leukemia

If you’d like to learn more about the stages of leukemia, the outstanding physicians in the Malignant Hematology Program at Moffitt Cancer Center can provide all of the information you need. These highly experienced physicians each specialize in a single disease discipline, such as leukemia. By focusing on one specific condition, our physicians have acquired extensive expertise, which translates to better treatments and outcomes for our patients.

“Risk models that integrate molecular information may provide better prediction on prognosis,” says Onyee Chan, MD, Malignant Hematology.

You do not need a referral to consult with the experts at Moffitt about the stages of leukemia. Call 1-888-663-3488 or complete a new patient registration form online.