Rai staging system for chronic lymphoid leukemia

Last revised by Dr Patrick J Rock on 13 May 2021

The Rai staging system is one of the two staging systems currently adopted in assessment of chronic lymphocytic leukemia (CLL).

It comprises of stages 0 to IV and classifies chronic lymphocytic leukemia into low, intermediate and high-risk categories, which correspond with stages 0, I and II, and III and IV, respectively:

  • Rai stage 0
    • low risk
    • lymphocytosis: a high lymphocyte count defined as more than 15,000 lymphocytes per cubic millimeter (> 15,000/mm3)
  • Rai stage I
  • Rai stage II
    • patients are also intermediate risk
    • lymphocytosis plus an enlarged liver (hepatomegaly) or enlarged spleen (splenomegaly), with or without lymphadenopathy
  • Rai stage III
    • patients are high-risk
    • lymphocytosis plus anemia with or without lymphadenopathy, hepatomegaly, or splenomegaly
  • Rai stage IV
    • high-risk
    • lymphocytosis + thrombocytopenia (< 100-103 /dL)

See also

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