Chronic lymphocytic leukemia: Staging
After the diagnosis of chronic lymphocytic leukemia, tests are done to determine the degree of spreading blood cancer and bone marrow. Staging is the process used to determine the extent of cancer spread. It is important to know the stage of the disease to plan the best treatment. The following tests may be used in the staging process:
- Bone marrow biopsy and aspiration: The removal of a small section of bone and marrow by inserting a needle into the hipbone or breastbone. A pathologist examines the sample to the microscope for abnormal cells.
- Ray: An x-ray of the organs and bones inside the chest. It is a type of energy beam that passes through the body and onto film, thereby generating a picture of areas inside the body, such as the lymph nodes.
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves and a computer to generate a series of detailed pictures of areas inside the body, such as brain and spinal cord. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- Computed Tomography (CT): A procedure that makes a series of detailed pictures of areas inside the body from different angles. The images are created by a computer linked to an x-ray machine A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- Studies of blood chemistry: A procedure in which a sample of blood to measure the amounts of certain substances released into the organ and tissue in the body. An unusual (higher or lower than normal) amount of a substance may indicate disease in the organ or tissue that produces it.
- Antiglobulin test: Analyzing a blood sample under a microscope to determine whether antibodies are present on the surface of red blood cells or platelets. These antibodies can react with red blood cells and platelets and destroy them. This test is also called a Coomb’s test.
Stage 0
In chronic lymphocytic leukemia stage 0, too many lymphocytes in the blood, but no other symptoms of leukemia. Chronic lymphocytic leukemia stage 0 is indolent (slow growing).
Stage I
In chronic lymphocytic leukemia stage I, there are too many lymphocytes in the blood and lymph node size is larger than normal.
Stage II
In chronic lymphocytic leukemia stage II, there are too many lymphocytes in the blood and the size of the liver or spleen is larger than usual and the same can happen with the lymph nodes.
Stage III
In chronic lymphocytic leukemia, stage III, there are too many lymphocytes in the blood and a very low number of red blood cells. The size of lymph nodes, liver or spleen may be larger than normal.
Stage IV
In chronic lymphocytic leukemia, stage IV, there are too many lymphocytes in the blood and a very low number of platelets. The size of lymph nodes, liver or spleen may be larger than normal and perhaps the red blood cell count is too low.
Refractory
Refractory chronic lymphocytic leukemia is cancer that does not improve with treatment.
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