Rai Staging System (CLL)

Additional Information

Score Description

The Rai staging system is a widely used staging system for chronic lymphatic leukemia (CLL).  The use of staging systems is recommended in recent CLL guidelines in order to help to guide therapy. Patients are grouped prognostically based on physical examination and blood counts. The Rai staging system comprises five stages.  The Rai system is based upon the concept that in CLL there is a gradual and progressive increase in the body burden of leukemic lymphocytes, starting in the blood and marrow (lymphocytosis),  progressively involving lymph nodes (lymphadenopathy), spleen and liver (organomegaly), with eventual compromise of bone marrow function (anemia and thrombocytopenia).


Stage Lymphocytosis
(> 15 G/L)
Lymphadenopathy Hepato- or Splenomegaly Hb [g/l] Platelets [G/L]
0 Yes No No > 110 ≥ 100
I Yes Yes No > 110 ≥ 100
II Yes Irrelevant Yes > 110 ≥ 100
III Yes Irrelevant Irrelevant < 110
≥ 100
IV Yes Irrelevant Irrelevant Irrelevant < 100
(= thrombocytopenia)

Further Reading

Rai KR et al. Clinical staging of chronic lymphocytic leukemia. Blood 1975; 46(2):219-34.