CLL/SLL with Rai stage 0 (lymphocytosis only, no nodes / spleen / cytopenia) — watch-and-...

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

ID	`RF-RAI-LOW`
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 Rai stage 0 (lymphocytosis only, no nodes / spleen / cytopenia) — watch-and-wait candidate; treatment is not indicated by stage alone
Clinical direction	de-escalate
Category	risk-score
Shifts algorithm	ALGO-CLL-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "cll_rai_stage",
      "value": "0"
    },
    {
      "finding": "cll_rai_risk",
      "value": "low"
    }
  ],
  "type": "composite_score"
}

Notes

Rai (Rai 1975, modified) staging stratifies CLL by clinical findings: 0 = lymphocytosis only; I = +nodes; II = +splenomegaly/hepatomegaly; III = anemia (Hb <11); IV = thrombocytopenia (plt <100K). Modified Rai groups: low = 0, intermediate = I-II, high = III-IV. Rai 0 has median OS >10 yr — same observation principle as Binet A. Active disease criteria (iwCLL 2018) override stage; this RF fires only when Rai 0 alone is the picture. Companion to RF-BINET-A.

Used By

Algorithms

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