Chronic Lymphocytic Leukemia (CLL) - Rai Classification

8/13/01

Question: What is the Rai classification for staging CLL?

[NOTE: the original publication is in #4]

<4>

Unique Identifier: 75184472 / PubMed Identifier: 1139039

Authors: Rai KR. Sawitsky A. Cronkite EP. Chanana AD. Levy RN. Pasternack BS.

Abstract: A method of clinical staging of chronic lymphocytic leukemia (CLL) has been proposed which is based on the concept that CLL is a disease of progressive accumulation of nonfunctioning lymphocytes: stage O, bone marrow and blood lymphocytosis only; stage 1, lymphocytosis with enlarged nodes; stage II, lymphocytosis with enlarged spleen or liver or both; stage III, lymphocytosis with anemia; and stage IV:lymphocytosis with thrombocytopenia. Analysis of 125 patients. in the present series showed the following median survival times (in months) from diagnosis: stage 0, is greater than 150; stage I 101; stage II, 71; stage III, 19; stage IV, 19, The median survival for the entire series was 71 mo. The prognostic significance of the stage remained even after adjustment was made for age and sex. However, both sex and age were shown to be poor predictors of survival after adjustment for stage. The method of staging proved to be a reliable predictor of survival whether used at diagnosis or during the course of the disease. The proposed staging system was an equally accurate indicator for survival when applied to two other previously published studies of large series of patients

<3>

Unique Identifier: 83050596 / PubMed Identifier: 7139586

Authors: Skinnider LF. Tan L. Schmidt J. Armitage G.

Abstract: Review of 745 cases of chronic lymphocytic leukemia show that clinical staging by either the Rai or Binet method is very valuable in assessment of patients at the time of diagnosis. There is a marked decrease in survival with advancing stage (19.9 years median survival for Rai Stage 0, and 2.5 years and 2.7 years for Rai Stages 3 and 4, respectively). The definition of anemia as Hb less than 11 g/dl as in the Rai staging method appears to give slightly better discrimination among the stages than the Binet staging procedure. Patients with splenomegaly alone (Binet stage 2), however, form a small but distinct group that should be recognized. These is little to be gained by subdividing further according to size of the lymph nodes.