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Binet staging for chronic lymphocytic leukaemia

Prognostic staging (A, B, C) by involved lymphoid areas and cytopenias.

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Binet stage
Score0low risk
low riskmoderate riskhigh risk

Binet stage A: fewer than three involved lymphoid areas, no anaemia or thrombocytopenia. Watch and wait is standard.

Evidence grade
A

What it is and when to use it

Binet staging classifies chronic lymphocytic leukaemia by the number of involved lymphoid areas — cervical, axillary and inguinal nodes (each counted once whether unilateral or bilateral), spleen and liver, five areas in total — and by the presence of anaemia or thrombocytopenia.

How to interpret it

Stage A: fewer than 3 involved areas, no anaemia or thrombocytopenia; watch and wait is the standard approach. Stage B: 3 or more involved areas, no anaemia or thrombocytopenia; treatment is given if active-disease criteria are met. Stage C: haemoglobin < 10 g/dL and/or platelets < 100 ×10⁹/L, regardless of the number of involved areas; treatment is generally indicated.

Limitations and when not to use it

Applies only to an already-diagnosed chronic lymphocytic leukaemia/small lymphocytic lymphoma; anaemia or thrombocytopenia must be confirmed as marrow-related (from infiltration) rather than autoimmune haemolysis or another peripheral cause, since that would misclassify the stage.

Formulas and cut-offs are from the original authors of each score; see the references.

Last reviewed: June 2026

References
  1. Binet JL, Auquier A, Dighiero G, et al. A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis. Cancer. 1981;48(1):198-206. PMID:7237385