Leukemias, like most cancers, are staged to help doctors and patients develop effective treatment strategies.
Staging is used to identify a cancer’s metastasis—the extent that the cancer has spread throughout the body. Bone marrow biopsies, chest X-rays, MRI’s, CT scans, blood tests, and antiglobin tests are are commonly employed to stage leukemia.
CHRONIC LYMPHOBLASTIC LEUKEMIA
- Stage 0: This stage describes slow-growing leukemias. An abundant amount of lymphocytes are present in the blood (over 10,000/mm3). In this stage, the patient presents no other symptoms of leukemia.
- Stage I: During this stage, the lymph nodes are enlarged and the blood has an abundant amount of lymphocytes.
- Stage II: In this stage, a surplus of lymphocytes is present in the blood and the liver, and the spleen and lymph nodes are enlarged.
- Stage III: In this stage, there are more lymphocytes in the blood than healthy red blood cells—this condition is known as anemia. Furthermore, the liver, spleen, and the lymph nodes are enlarged.
- Stage IV: This stage describes patients with an abundant number of lymphocytes in the blood and low counts of healthy red blood cells and platelets (thrombocytopenia). The liver, spleen and lymph nodes are enlaged.
ACUTE LYMPHOBLASTIC LEUKEMIA
Acute lymphoblastic leukemia is not staged. This disease is, by definition, an advanced cancer of the blood that has already spread throughout the body at the time of diagnosis. Therefore, risks groups are used to help doctors and patients develop effective treatment plans.
Risks groups are categorized as low risk, high risk, or recurrent.
- Low Risk: This risk group describes children between the ages of 1-9 years old with a white blood cell (WBC) count of approximately 50,000/µL at the time of the diagnosis.
- High Risk: This risk group describes children that are either younger than 1 or older then 9 years of age who have a WBC count of 50,000/µL or greater. Children with high-risk acute lymphoblastic leukemia usually require more aggressive treatment.
- Recurrent: This risk group describes patients who, even after their cancer has been successfully treated, continue to develop acute lymphoblastic leukemia. The leukemia may recur within the blood, bone marrow, spinal cord, brain, and/or other locations throughout the body.
The early stages of acute mylogenous leukemia can easily be mistaken for the flu or other common illnesses.
The term “acute” describes myelogenous leukemias that have spread beyond the blood and the bone marrow. Acute myelogenous leukemia is not staged. Instead, the cancer is categorized as either untreated, in remission, or recurrent.
- Untreated: This group describes patients who present signs and symptoms of leukemia and who have been diagnosed with an abnormal complete blood count—approximately 20% of the cells within the bone marrow are blasts (immature blood cells of any type).
- Remission: In remission, the cancer has been treated and the patient has a normal complete blood count—less than 5% of the cells in the bone marrow are blasts. Patients in remission present no signs or symptoms of leukemia.
- Recurrent: This group describes patients who, even after their cancer has been successfully treated, continue to develop acute myelogenous leukemia. The leukemia may recur within the blood or bone marrow.
- Chronic Phase: The term “chronic” describes a leukemia that is stable and and slow-growing. 90% of people with chronic myelogenous leukemia are diagnosed during the chronic phase. Chronic myelogenous leukemia is characterized by blast (immature blood cell) counts of less than 10% within the blood and bone marrow. In chronic myelogenous leukemia, there are no other symptoms of leukemia present.
- Accelerated Phase: In this phase, the patient’s blast cell count is approximately 10-19%. Patients in this stage will display some signs of leukemia, including tiredness and weight loss.
- Blastic Phase: This stage is fast-growing and aggressive. In the blastic phase, over thirty percent of the total cells in the blood and bone marrow are blasts (immature blood cells of any type). Blasts form tumors within the bone, skin, lungs, brain or lymph nodes.
Other Staging Terms and Concepts
Sometimes leukemias are described using the the terms low risk, intermediate risk, or high risk:
Low Risk: This group describes Stage 0 leukemias.
Intermediate Risk: This group describes Stages I and II leukemias.
High Risk: This group describes Stages III and IV leukemias.
MedTV. Retrieved February 25, 2011.
Mayo Clinic. Retrieved February 25, 2011.
National Cancer Institute. Retrieved February 25, 2011.
American Cancer Society. Retrieved February 25, 2011.
University of Mariland—Greenebaum Cancer Center. Retrieved February 25, 2011.