**Note 1:** For cases diagnosed 1/1/2018 and later, all cases of CLL and SLL will require both the **Lugano classification, which is captured in the AJCC stage group data item, and the five components of the modified Rai staging system, which are captured in Site-Specific Data Items (adenopathy, anemia, lymphocytosis, organomegaly, and thrombocytopenia).**
The terms B-cell lymphocytic leukemia/chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are considered different clinical presentations of the same disease, with both terms coded 9823. Traditionally the lymphoma diagnosis was staged with the Ann Arbor staging system and it is now staged with the Lugano classification. In North America, CLL was staged with the Rai system.
**Note 2:** Lymphocytosis (lymphocyte number) is defined by an absolute lymphocyte count (ALC) > 5,000 cells/μL and is part of the staging criteria.
* Use the cut points listed in the table regardless of the lab’s reference range
* For cases that document lymphocyte count in SI (Systeme Internationale) units as any of 10*9/L, 10^9/L, or 10E9/L, the cut point of 5,000 cells/µL is equivalent to (5 cells x 10*9/L), (5 cells X 10^9/L), or (5 cells x10E9/L).
**Note 3:** Record this data item based on a blood test (CBC and differential) performed at diagnosis (pre-treatment). In the absence of the lab test, a physician’s statement can be used.
**Note 4:** If the presence/absence of lymphocytosis determined by available lab values differs from the physician’s statement of lymphocytosis, the lab value takes precedence.
**Note 5:** If there is no mention of lymphocytosis, or relevant lab results, code 9.