Chronic lymphocytic leukemia (CLL) has a relatively high survival rate. But rates can vary widely, depending on the stage and specific cellular and genetic characteristics of the disease.
CLL is a type of cancer that affects the blood and bone marrow. Bone marrow is a soft, spongy substance within bones that produces blood cells.
CLL is the result of various genetic mutations in the DNA of cells that produce blood. These DNA changes occur over the course of a lifetime, rather than like other genetic changes that are passed down before birth.
If you receive a diagnosis of CLL, your bone marrow produces too many lymphocytes, which are a type of white blood cell. These lymphocytes don’t function properly. They cause further problems by getting in the way of other blood cells.
According to the
However, various factors can affect your outlook and life expectancy with CLL. As researchers continue to learn more about CLL, it becomes clearer how difficult it can be to predict outcomes.
CLL has a higher survival rate than many other types of cancer. The 5-year relative survival rate for adults with CLL is around
But survival rates vary depending on the stage of the disease. Doctors use various staging systems to assess someone’s outlook with CLL, including:
- Rai staging system
- Binet staging system
- CLL International Prognostic Index (CLL-IPI) score
Regardless of which system doctors use, staging is determined based on various factors, such as blood counts and any involvement of the lymph nodes, liver, and spleen.
CLL survival rates by Rai stage
Doctors in the United States more commonly use the Rai staging system, which categorizes CLL in
- Stage 0: low risk
- Stages 1 to 2: intermediate risk
- Stages 3 to 4: high risk
Risk defines how quickly the disease is likely to progress. The higher the risk, the more quickly CLL is expected to advance.
There’s not a lot of recent research matching survival rates to Rai stages. But in general, a higher stage means a lower survival rate.
CLL survival rates by Binet stage
Doctors in Europe more commonly use the Binet staging system. This system uses three stages that consider the number of affected areas of lymphoid tissue and whether you have symptoms like anemia (low red blood cells) and thrombocytopenia (low platelets).
A 2020 study found the following overall survival times for people with CLL according to Binet stage:
| Binet stage | Description | Median overall survival |
|---|---|---|
| A | fewer than three affected areas and no anemia or thrombocytopenia | 13.9 years |
| B | three or more affected areas and no anemia or thrombocytopenia | 9.2 years |
| C | any number of affected areas but you have anemia, thrombocytopenia, or both | 7.9 years |
It’s worth noting that survival periods in the study ranged from 0.1 to 37.4 years, indicating how varied CLL survival can be.
CLL survival rates by CLL-IPI
The CLL-IPI is a newer model that doctors can use to determine risk, guide treatment, and predict survival. It scores risk on a scale of 1 to 10.
According to the Canadian Cancer Society, the 5-year overall survival rates based on CLL-IPI are:
| CLL-IPI score | Category | 5-year overall survival rate |
|---|---|---|
| 0 to 1 | low risk | 93% |
| 2 to 3 | intermediate risk | 79% |
| 4 to 6 | high risk | 63% |
| 7 to 10 | very high risk | 23% |
There’s no cure for CLL, but many people live with the disease for several years. Some people even live for many years
However, CLL primarily affects older adults. According to the American Cancer Society, the average age at diagnosis is
CLL also raises your risk of infections. Some studies suggest that as many as half of people with CLL may eventually die from a CLL-related infection.
What is life expectancy for people with chronic lymphocytic leukemia?
Half of all people with CLL live for
Your life expectancy with CLL can also be very dependent on your age at diagnosis and several other factors specific to the course of the disease.
Several factors influence your outlook with CLL, including:
- the stage of the disease
- how quickly your lymphocyte count increases
- how well you respond to treatment
- specific cellular and genetic markers
Lymphocyte count and CLL outlook
Your lymphocyte count is a measure of how many lymphocytes are in your blood. Research suggests that how quickly lymphocytes multiply in your blood may show how CLL is progressing.
Doctors measure this by lymphocyte doubling time (LDT), which is the amount of time it takes for the number of lymphocytes in your blood to double.
An LDT of 12 months or less typically suggests a less favorable outcome.
An LDT of longer than 12 months typically suggests a more favorable outcome and a longer time before requiring treatment.
Treatment response to CLL
Treatment may not be necessary right away if results from your bone marrow biopsy, imaging tests, and blood tests reveal an early stage with low risk. Age, disease risk, and symptoms all play a role in determining treatment options.
According to the Leukemia & Lymphoma Society, there’s no proof that aggressive treatment of early stage CLL extends life expectancy. Many doctors forgo treatment at the early stage so you don’t experience side effects and possible complications.
Instead, doctors will regularly monitor the disease and only recommend treatment when it progresses.
If you receive a diagnosis at a more advanced stage of CLL with a higher risk, different treatments can improve your survival rate.
Treatments usually include a combination of chemotherapy drugs to kill cancer cells.
You may also be a candidate for a stem cell transplant. In this procedure, you’ll receive healthy adult blood stem cells from a donor. This can stimulate the production of your own healthy blood cells. This treatment offers some people with CLL the possibility of remission but has become less common since the introduction of new targeted medications.
Open communication between you and your cancer specialist or oncologist is essential. They’re an excellent resource for up-to-date information regarding your treatment and care.
Biomarkers and CLL outlook
The absence or presence of various cell markers complicates the outcomes of people with CLL. These are proteins and other molecules that can indicate the presence or progress of a disease. Biomarkers that may influence your outlook with CLL include:
- beta-2 microglobulin
- thymidine kinase
- CD38
- CD49d
- ZAP70
Doctors may also look for specific genetic changes (mutations) that may affect your outlook with CLL, particularly mutations in the immunoglobulin heavy chain variable region (IGHV) gene.
In younger people who haven’t received previous treatment, are in overall good health, and have certain favorable biomarkers, the combination chemotherapy called FCR (fludarabine, cyclophosphamide, and rituximab) has shown great promise.
However, this treatment approach isn’t for everyone. Those over 65 years old, people with poor kidney function, and those with other health conditions may not tolerate this treatment.
In some people, this approach can also increase the risk of infection and other cancers.
Living with CLL can bring on a variety of emotions. Some days, you may feel good. Other days, not so good. At times, you may feel overwhelmed, angry, afraid, nervous, or hopeful.
Even if you’re in the low risk stage of CLL and not receiving treatment, you may fear the progression of the disease. Consider the following self-care tips:
- Express your feelings: Find opportunities to open up about how you feel. Consider talking with a trusted family member, writing in a journal, or joining a cancer support group to connect with others.
- Educate yourself: Research the condition and stay up-to-date on the latest treatments so you can ask thoughtful questions at each checkup. Take notes during your appointments and ask your doctor to clarify any information you don’t understand.
- Stay active: Staying active can improve your mood, reduce fatigue, and boost your immune system to help you fight disease. A 2024 test-tube study also suggests that exercise may enhance the effectiveness of certain CLL medications.
- Take your mind off disease: Finding enjoyable activities that help you unwind and relax can help take your mind off your diagnosis. Explore a hobby, such as photography, art, dance, or crafts. Consider guided imagery meditation to help you relax and reduce stress.
Educational CLL resources
It’s important to find reliable information when looking online. Check out reputable sources such as:
American Cancer Society - Leukemia & Lymphoma Society
National Cancer Institute
Ask your doctor for recommendations on where else you can learn more about your condition.
CLL is a type of cancer that affects the blood and bone marrow. General survival rates are higher for CLL than for other types of cancer. But your specific outlook can vary based on a variety of factors.
There’s no cure for CLL, but certain treatments can improve survival rates for some people. Work with your doctor to learn more about your specific outlook and proper next steps.