Chronic lymphocytic leukemia

Request an Appointment

Stages

If you're diagnosed with chronic lymphocytic leukemia (CLL), the next step is to determine the cancer's extent, called the stage. Imaging tests and blood tests may be used to determine the stage of your chronic lymphocytic leukemia. Your healthcare team uses the cancer stage to help create your treatment plan.

Chronic lymphocytic leukemia stages can use letters or numbers. In general, the earliest stages of cancer may not cause symptoms and don't need to be treated right away. People with cancer in the later stages may have symptoms and need treatment right away. The numbered stages include:

  • Stage 0 chronic lymphocytic leukemia. At stage 0, the number of lymphocytes in the blood is higher than usual. This is a condition known as lymphocytosis.
  • Stage 1 chronic lymphocytic leukemia. Stage 1 involves lymphocytosis with enlarged lymph nodes.
  • Stage 2 chronic lymphocytic leukemia. Stage 2 involves lymphocytosis with an enlarged spleen or liver. The lymph nodes also may be enlarged.
  • Stage 3 chronic lymphocytic leukemia. Stage 3 involves lymphocytosis and a condition characterized by a lack of healthy red blood cells, called anemia. Stage 3 also may include an enlarged spleen or liver and enlarged lymph nodes.
  • Stage 4 chronic lymphocytic leukemia: Stage 4 involves lymphocytosis and a condition characterized by low platelet counts, called thrombocytopenia. Stage 4 also may include an enlarged spleen or liver, enlarged lymph nodes, and anemia.

The lettered stages include:

  • Stage A is lymphocytosis with less than three lymph nodes regions involved.
  • Stage B is lymphocytosis with three or more lymph node regions involved.
  • Stage C is lymphocytosis with anemia or thrombocytopenia. The lymph nodes and an enlarged spleen may or may not be involved.
Request an appointment
Diagnosis & treatmentSurvival rates
Oct. 24, 2025

Living with chronic lymphocytic leukemia?

Connect with others like you for support and answers to your questions in the Blood Cancers & Disorders support group on Mayo Clinic Connect, a patient community.

Blood Cancers & Disorders Discussions

atir
Polycythemia Vera: Just been diagnosed

431 Replies Thu, Nov 13, 2025

anavleek
Essential thrombocythemia (ET): When to start hydroxyurea (HU)?

110 Replies Thu, Nov 13, 2025

sandramgus
Diagnosed: MGUS

139 Replies Thu, Nov 13, 2025

See more discussions
  1. Niederhuber JE, et al., eds. Chronic lymphocytic leukemia. In: Abeloff's Clinical Oncology. 6th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Sept. 8, 2025.
  2. Kaushansky K, et al., eds. Chronic lymphocytic leukemia. In: Williams Hematology. 10th ed. McGraw Hill; 2021. https://accessmedicine.mhmedical.com. Accessed Sept. 8, 2025.
  3. Stilgenbauer S. Overview of the complications of chronic lymphocytic leukemia. https://www.uptodate.com/contents/search. Accessed Sept. 8, 2025.
  4. Chronic lymphocytic leukemia/small lymphocytic leukemia. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1478. Accessed Sept. 8, 2025.
  5. Chronic lymphocytic leukemia treatment (PDQ) — Patient version. National Cancer Institute. https://www.cancer.gov/types/leukemia/patient/cll-treatment-pdq. Accessed Sept. 8, 2025.
  6. Chronic lymphocytic leukemia (CLL). Blood Cancer United. https://bloodcancerunited.org/blood-cancer/leukemia/chronic-lymphocytic-leukemia-cll. Accessed Sept. 8, 2025.
  7. Rosenthal DS, et al. Evaluation of the peripheral blood smear. https://www.uptodate.com/contents/search. Accessed Sept. 8, 2025.
  8. Targeted therapy to treat cancer. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies. Accessed Sept. 8, 2025.
  9. Chemotherapy to treat cancer. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/types/chemotherapy#chemotherapy-can-cause-side-effects. Accessed Sept. 8, 2025.
  10. Immunotherapy side effects. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/side-effects. Accessed Sept. 8, 2025.
  11. Radiation therapy side effects. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/side-effects. Accessed Sept. 8, 2025.
  12. Stem cell transplants in cancer treatments. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant#stem-cell-transplant-side-effects. Accessed Sept. 8, 2025.
  13. T-cell transfer therapy. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/t-cell-transfer-therapy. Accessed Sept. 8, 2025.
  14. Cancer-related fatigue. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1424. Accessed Sept. 8, 2025.
  15. Cancer stat facts: Leukemia — chronic lymphocytic leukemia (CLL). National Cancer Institute. https://seer.cancer.gov/statfacts/html/clyl.html. Accessed Sept. 8, 2025.
  16. Warner KJ. Allscripts EPSi. Mayo Clinic. Feb. 8, 2021.
  17. Shanafelt TD, et al. Hematologist/oncologist disease-specific expertise and survival: Lessons from chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL). Cancer. 2012; doi:10.1002/cncr.26474.
  18. Ding W, et al. Pembrolizumab in patients with CLL and Richter transformation or with relapsed CLL. Blood. 2017; doi:10.1182/blood-2017-02-765685.
  19. Elsevier Point of Care. Clinical Overview: Febrile neutropenia in adults. https://www.clinicalkey.com. Accessed Sept. 8, 2025.
  20. Larson RA, et al. Tumor lysis syndrome: Prevention and treatment. https://www.uptodate.com/contents/search. Accessed Sept. 8, 2025.

Related

Associated Procedures

Products & Services

Chronic lymphocytic leukemia