CLL Staging — Rai & Binet

Name: CLL Staging — Rai & Binet calculator — MedScore
Creator: Nabil Alzein

Chronic lymphocytic leukaemia: Rai (with modified risk groups) and Binet clinical stages from the same findings

Enlarged on examination (each area counts once, uni- or bilateral)

Cervical lymph nodes

Axillary lymph nodes

Inguinal lymph nodes

Spleen (splenomegaly)

Liver (hepatomegaly)

Haemoglobin

Platelets (×10³/µL = ×10⁹/L)

Enter haemoglobin and platelets to stage

About this score

When to use

Stages chronic lymphocytic leukaemia with both systems: Rai 0–IV (lymphocytosis, nodes, liver or spleen, anaemia, thrombocytopenia) and Binet A–C (number of involved areas and blood counts). ⁦[1, 2]⁩

Pearls and pitfalls

• Immune-mediated cytopenias do not count toward Rai III/IV or Binet C, and staging assumes a confirmed CLL diagnosis. ⁦[3]⁩

• Modified Rai risk groups: low (0), intermediate (I–II) and high (III–IV). ⁦[3]⁩

Summarised from the numbered sources under Evidence. Check the source before relying on a statement.

Evidence

[1] Original publication

Rai KR, Sawitsky A, Cronkite EP, et al. Clinical staging of chronic lymphocytic leukemia. Stages 0–IV: lymphocytosis alone; with lymphadenopathy; with hepatomegaly or splenomegaly; with anaemia (haemoglobin < 11 g/dL); with thrombocytopenia (< 100,000/mm³).

Blood, 1975

Open source

[2] Validation

Binet JL, Auquier A, Dighiero G, et al. A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis. Stages A, B and C from the number of involved areas (cervical, axillary and inguinal nodes, spleen, liver) and haemoglobin < 10 g/dL or platelets < 100 × 10⁹/L.

Cancer, 1981

Open source

[3] Guideline

PDQ® Adult Treatment Editorial Board. Chronic Lymphocytic Leukemia Treatment (PDQ®) – Health Professional Version. National Cancer Institute — Rai and Binet tables (its Binet footnote lists four areas, without the liver). Modified Rai risk groups: low (0), intermediate (I–II), high (III–IV). Immune-mediated cytopenias do not count toward stage III/IV or C. Staging assumes a confirmed CLL diagnosis.

Open source

Last reviewed: 2026-10

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MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.