Chronic lymphocytic leukemia (CLL) tends to have a better outlook than most other types of leukemia. About 88% of adults over the age of 20 years live for 5 years post-diagnosis, and some can live much longer.
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 determine 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 all 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. Currently, in the United States, people over 20 years with CLL have a 5-year relative survival rate of
According to one 2018 paper, about one-third of people have CLL with an indolent course, meaning the cancer grows very slowly. They 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 chance of surviving CLL.
Researchers have developed
- the Rai staging system
- the Binet staging system
- the 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 consists of 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 3.5 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 stage. 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
Support your overall health with a healthy diet, plenty of rest, and regular exercise. When exercising, listen to your body to avoid overexerting yourself.
Having CLL also increases your risk of developing an infection, so healthcare professionals advise people to take precautions to avoid germs. These include:
- washing your hands regularly
- getting your vaccines regularly
- wearing a mask when around people with infections
In a 2019 study, about
People without a mutation in their IGHV gene tend to have much more aggressive disease, whereas the indolent form of the condition tends to progress very slowly.
How long it takes to progress overall depends on factors such as whether there’s a gene mutation and the time it takes to develop enough symptoms to warrant treatment.
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.
Can I live a regular life with CLL?
While CLL isn’t likely to be cured, it’s possible to live a long time with the disease. You’ll need to follow any treatment and lifestyle changes your doctor recommends. This
Is CLL classed as terminal?
Although CLL is rarely curable, it’s also rarely terminal. About
What is the longest a person has lived with CLL?
According to research from the 1980s, the longest a person has lived with CLL was
What are the symptoms of end stage CLL?
In cases of late stage or rapidly progressing CLL, symptoms may include frequent infections, severe anemia, bleeding or bruising, fatigue, and neurological symptoms.
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 symptoms and prolong your survival.