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
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
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.
| Risk | Characteristic |
|---|---|
| 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.
| Stage | Characteristics |
|---|---|
| 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.
| Factor | Points |
|---|---|
| age over 65 years | 1 |
| Binet stage B or C or Rai stage 1 to 4 | 1 |
| concentration of beta-2 microglobulin in your blood over 3.4 mg/L | 2 |
| no associated mutation in IGHV gene | 2 |
| TP53 gene mutation or deletion | 4 |
A doctor will use your total score to place your CLL into one of four categories.
| Category | Points | Usual treatment |
|---|---|---|
| low risk | 0 to 1 | no treatment |
| intermediate risk | 2 to 3 | no treatment unless problematic symptoms |
| high risk | 4 to 6 | treatment unless no symptoms |
| very high risk | 7 to 10 | new 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.
| Stage | 3-year survival rate |
|---|---|
| low risk | 100% |
| intermediate risk | 96% |
| high risk | 93.9% |
| very high risk | 89.4% |
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
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
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
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.
