Binet et al

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Binet et al. (11) recognized the need for a staging system with fewer stages than in the Rai schema and proposed another CLL staging system (originally in 1977 and revised in 1981; Table 2). Binet's system divided patients into three stages. Stage C included patients with anemia (hemoglobin <10 g/dL) or thrombocytopenia (platelet count <100,000/|L) or both. All the remaining (non-stage C) patients were subdivided on the basis of whether they had three or more areas of lymphoid enlargement (stage B), or only two or fewer areas of lymphoid enlargement (stage A). The five lymphoid areas considered in this system are cervical, axillary, inguinal (unilateral or bilateral, single node or multiple nodes), spleen, and liver. Binet et al subsequently validated the usefulness of their staging system in a large series of patients.

Fig.1. Three-stage modified Rai staging system. (Adapted from ref. 5.)

Table 2

Staging System of Binet et al. and the International Workshop on CLL (IWCLL)

Clinical stage Features

A No anemia or thrombocytopenia and fewer than three areas of lymphoid enlargement

B No anemia or thrombocytopenia, with three or more involved areas.

C Anemia and/or thrombocytopenia regardless of the number of area s of lymphoid enlargement

C (III) or C (IV)a a IWCLL-recommended Rai-Binet integrated staging system.

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