Leukemia is a condition in which the bone marrow produces abnormal white blood cells and these cells are called leukemia cells.
Normally, blood cells will form in the bone marrow, a soft material in the center of bones.
The blood cells will get matured in the bone marrow from immature blood cells called blasts or stem cells forming different types of blood cells and each type has its own function.
They include red blood cells, which carries oxygen to the tissues, white blood cells, which helps to fight infections, and platelets, which forms clotting of the blood to prevent blood loss. These matured blood cells will move into the blood vessels.
Leukemia is classified into two forms, acute and chronic. Further, these diseases are classified into lymphocytic and myelogenous. Combining this, there are four major different forms of leukemia. They include acute lymphocytic leukemia, acute myelogenous leukemia, chronic lymphocytic leukemia, and chronic myelogenous leukemia.
Depending on the size of the tumor and spreading of the cancer to different organs of the body such as liver, spleen, etc, there are different stages given to the cancer (stage I, II, III, and IV). Also, there are different staging systems for different types of chronic leukemia and for some types there is no staging system at all.
Stages of chronic myelogenous leukemia:
Chronic myelogenous leukemia (CML) has been divided into three stages (often called as phases by doctors).
Chronic phase. The patients in this phase will have mild symptoms and they usually respond to standard treatments. The blood and bone marrow samples will have 5% blasts.
Accelerated phase. In this phase, the patient’s bone marrow and blood samples will have more than 5% and fewer than 30% blasts. The symptoms like fever, weight loss, poor appetite and blood counts are not that responsive when compared to chronic phase.
Blast phase (acute phase). The bone marrow and blood samples will have more than 30% blasts during this phase. By this phase, the chronic leukemia is transformed to aggressive acute leukemia.
Staging systems in chronic lymphocytic leukemia:
For chronic lymphocytic leukemia (CLL), there are two different staging systems. In the United States, Rai classification is used and in Europe, Binet classification is used.
Rai classification separates CLL into low, intermediate, and high-risk categories.
Rai Stage 0 patients are at low risk with lymphocytosis (lymphocytic count is too high).
Rai Stage I patients are at intermediate risk with lymphocytosis and lymph nodes enlargement.
Rai Stage II patients are also at intermediate risk and have lymphocytosis plus enlarged liver and spleen, with/without lymphadenopathy.
Rai Stage III patients are at high risk with lymphocytosis and anemia, with/without lymphadenopathy and enlarged liver and spleen.
Rai Stage IV patient are also at high risk with lymphocytosis plus thrombocytopenia.
Based on the number of lymphoid tissues involved in the spleen and lymph nodes of the neck, groin, and underarm areas, anemia, and thrombocytopenia, Binet Staging classifies CLL into Binet Stage A, Binet Stage B, and Binet Stage C.
For acute leukemia, the most famous classification is French-American-British system.
Reduce leukemia by appropriate treatment in the initial stages only.