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SEER Training Modules

Staging

Relationship to TNM Staging

Anatomic staging is not applicable to the leukemias.

Relationship to Summary Staging

All leukemias are considered disseminated at time of diagnosis.

Prognostic and Therapeutic Stagings

Chronic Lymphocytic Leukemia (RAI Staging)
Stage Description
Stage 0 Lymphocytosis greater than 5,000 cell/mm and greater than 40% of cells in the bone marrow
Stage 1 Lymphocytosis with large lymph nodes
Stage 2 Lymphocytosis with enlargement of spleen and/or liver
Stage 3 Lymphocytosis and marrow replacement resulting in anemia
Stage 4 Lymphocytosis and low platelet due to marrow replacement

International Workshop on CLL Clinical Staging

  • Clinical stage A
    • No anemia or thrombocytopenia, < 3 areas of lymphadenopathy
      (Rai Stage 0, I, II)
  • Clinical stage B
    • No anemia or thrombocytopenia, > or = 3 areas of lymphadenopathy (Rai Stage I - II)
  • Clinical stage C
    • Anemia and/or thrombocytopenia (Rai Stage III - IV)

There are no staging systems for other blood diseases. The acute leukemias and myelodysplastic syndromes are described and classified histologically by the French-American-British (FAB) classification.

An International Prognostic Scoring System has been developed for MDS, based on the bone marrow blast percentage, number of peripheral blood cytopenias, and cytogenetic subgroup, which stratifies cases into four risk groups. In addition, other prognostic classification systems for MDS include the FAB system (described above), the Bournemouth score, the Sanz score, and the Lille score.

Collaborative Stage Elements

For more details on Collaborative Stage, see the Intro to Collaborative Staging module.