CLL/SLL with Binet stage B (≥3 lymphoid areas, no cytopenia) or C (Hb <10 OR platelets <1...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-BINET-B-C`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-CLL`
Sources	`SRC-ESMO-CLL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	CLL/SLL with Binet stage B (≥3 lymphoid areas, no cytopenia) or C (Hb <10 OR platelets <100K) — meets treatment indication; supports BTKi-based 1L (ibrutinib / acalabrutinib / zanubrutinib) or venetoclax+obinutuzumab fixed-duration
Clinical direction	intensify
Category	risk-score
Shifts algorithm	ALGO-CLL-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "cll_binet_stage",
      "value": "B"
    },
    {
      "finding": "cll_binet_stage",
      "value": "C"
    },
    {
      "finding": "cll_binet_risk",
      "value": "intermediate"
    },
    {
      "finding": "cll_binet_risk",
      "value": "high"
    }
  ],
  "type": "composite_score"
}

Notes

Binet B = ≥3 lymphoid areas, no cytopenia, median OS ~5-7 yr. Binet C = anemia (Hb <10) or thrombocytopenia (plt <100K) due to marrow infiltration, median OS ~2-3 yr without modern targeted therapy. iwCLL 2018 active-disease criteria are met by Binet C and by progressive Binet B; supports moving to systemic therapy. 1L options per CLL14 (ven+G fixed 12 mo), iLLUMINATE (ibrutinib+G), ELEVATE-TN (acalabrutinib +/- G), SEQUOIA (zanubrutinib). Direction is intensify only relative to Binet A's watch-and-wait baseline.

Used By

Algorithms

ALGO-CLL-1L - ALGO-CLL-1L