5 Stages of Chronic Lymphocytic Leukemia (CLL): A Deep Dive into B-cell Chronic Lymphocytic Leukemia

Stage I (One): Lymph Node Involvement

Lymph Node Involvement

Stage I takes a leap from the silent onset of Stage 0, transitioning into a phase that showcases tangible markers. One of the most distinct indicators at this juncture is the enlargement of the lymph nodes. Located throughout the body, lymph nodes serve as filters that trap viruses, bacteria, and other causes of illnesses before they can infect other body parts. When CLL enters Stage I, these nodes, charged with producing and storing cells that combat infections, begin to swell. This isn’t a mere puffiness but an indication of a more concerning underlying condition. The accumulation of abnormal B-cells within the nodes results in this noticeable swelling.

While Stage 0 was characterized by an elevated lymphocyte count, Stage I moves the narrative forward, ushering in palpable physical changes. This isn’t about mere numbers anymore; the disease showcases itself through these swollen lymph nodes. The curious aspect? They usually aren’t painful. Often, their discovery is incidental, perhaps during a routine examination or even a self-check. For patients, the realization that their bodies are housing these enlarged nodes, without the accompaniment of pain or extreme discomfort, can be both surprising and concerning.

Understanding the centrality of lymph nodes in our immune system offers insights into why they become key players in Stage I CLL. These nodes, pivotal in producing and storing immune cells, are naturally the grounds where excessive, abnormal B-cells would congregate. As these rogue cells multiply, they choose lymph nodes as their residence, leading to the swelling. Essentially, the body’s defense system, instead of protecting, becomes the playground for the disease, highlighting the betraying nature of CLL.

Upon detecting the enlarged lymph nodes, the immediate question veers towards treatment. Stage I, despite its visible symptoms, doesn’t always command aggressive intervention. The roadmap is highly individualized. Factors such as the size, location, and number of swollen nodes come into play. While some patients might continue with the watchful waiting strategy, for others, the commencement of treatment becomes essential. Especially when swollen nodes begin affecting daily activities or pose a risk of further complications, medical interventions become paramount.


The journey from Stage 0 to Stage I is like crossing a threshold. From invisible changes confined to blood tests, we move to evident, palpable shifts. While it signifies the progressing nature of CLL, it also emphasizes the body’s signals. These enlarged nodes are cries for attention, urging patients to listen, understand, and act. Stage I might be an escalation, but with the right knowledge and timely intervention, it’s a phase that can be effectively managed, controlling the disease’s momentum. (2)

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