Chronic lymphocytic leukemia (CLL) tends to have a better outlook than most other types of leukemia. Despite doctors generally considering the condition incurable, some people live for decades after their diagnosis.

Doctors classify leukemias as “acute” if they tend to develop quickly and “chronic” if they develop more slowly. CLL is usually a slow-growing form of leukemia, but some subtypes can be aggressive.

CLL isn’t usually curable, but some people need little or no treatment. The survival rates for CLL and most other types of leukemia continue to improve as researchers develop new treatments and figure out which combinations are most effective.

Keep reading to learn more about the life expectancy of people with CLL and the factors that influence survival.

About half of people with CLL survive for at least 10 years, but the survival period can range from 2 years to more than 20 years.

Doctors often use 5-year relative survival rates to report cancer survival rates. The 5-year relative survival rate is a measure of how many people with the cancer are alive 5 years later compared with people without the cancer. From 2014 to 2020 in the United States, people with CLL had a 5-year relative survival rate of 88.5%.

According to one 2018 paper, about one-third of people have CLL with an indolent course, meaning the cancer grows very slowly. These people have similar survival rates as people without CLL.

The same paper claims that about 10% of people have an aggressive form. Only about half of those people live for longer than 1 to 3 years.

Many factors can influence the chances of surviving CLL.

Researchers have come up with various systems for estimating the outlook for CLL, including the:

  • Rai staging system
  • Binet staging system
  • International Prognostic Index for Chronic Lymphocytic Leukemia (CLL-IPI)

Rai staging system

The Rai staging system classifies CLL into three categories.

RiskCharacteristic
low risk (stage 0)abnormal increase of lymphocytes, a type of white blood cell, in your blood and bone marrow
intermediate risk (stages 1 and 2)abnormal increase of lymphocytes in your blood and bone marrow with either:

enlarged lymph nodes

OR

• an enlarged spleen, liver, or both
high risk (stages 3 and 4)abnormal increase of lymphocytes in your blood and bone marrow with either:

anemia, or a low red blood cell count

OR

thrombocytopenia, or a low platelet count

Binet staging system

The Binet staging system is broken into stages A to C.

StageCharacteristics
A• no anemia
• no thrombocytopenia
• fewer than 3 areas of enlarged lymph tissue
B• no anemia
• no thrombocytopenia
• 3 or more areas of lymph tissue enlargement
C• anemia
• thrombocytopenia
• any number of areas of lymph tissue enlargement

CLL-IPI

The CLL-IPI uses a point system and considers five factors for determining your outlook.

FactorPoints
age over 65 years1
Binet stage B or C or Rai stage 1 to 41
concentration of beta-2 microglobulin in your blood over 3.4 mg/L2
no associated mutation in IGHV gene2
TP53 gene mutation or deletion4

A doctor will use your total score to place your CLL into one of four categories.

CategoryPointsUsual treatment
low risk0 to 1no treatment
intermediate risk2 to 3no treatment unless problematic symptoms
high risk4 to 6treatment unless no symptoms
very high risk7 to 10new treatments or clinical trials, if being treated

In a 2024 study, researchers reported the following 3-year survival rates for people in each of these stages. They received treatment with targeted therapy drugs or chemotherapy and immunotherapy.

Stage3-year survival rate
low risk100%
intermediate risk96%
high risk93.9%
very high risk89.4%

Before, during, and after your treatment, it’s important to go to all your scheduled appointments so that your healthcare team can monitor the progression of your condition.

Treatment usually doesn’t aim to cure the condition, but it can slow down CLL’s progression and minimize your symptoms. Your doctor might not recommend treatment right away if you have low risk CLL.

It’s also a good idea to support your overall health with a healthy diet, plenty of rest, and regular exercise. When exercising, it’s best to listen to your body to avoid overexerting yourself.

Having CLL also increases your risk of developing an infection, so it’s a good idea to take precautions to avoid germs. These include:

  • washing your hands regularly
  • getting your vaccines regularly
  • wearing a mask when around people with infections

Learn more about managing daily life with CLL.

The progression rate of CLL can vary significantly among people. The indolent form of the condition tends to progress very slowly. Previous studies have found that only about one-quarter to one-fifth of people with the indolent form have evidence of progression after 1 year.

People with a mutation in their IGHV gene tend to have much more aggressive disease. Half of those people pass away within 1 to 3 years.

Most people who have an initial response to treatment will relapse at some point in the first 5 years of their treatment. If this happens to you, your healthcare team may recommend switching your treatment or increasing the dosage of your medications.

CLL generally has a better outlook than other forms of leukemia, but the outlook can vary widely. Some people have comparable survival to people without leukemia, and others may only live for 1 to 3 years after their diagnosis.

Your doctor can predict how aggressive your cancer will be based on factors such as the presence of certain gene mutations, your age, and your blood cell levels. Treatment usually doesn’t cure CLL, but it can help minimize your symptoms and prolong your survival.