Anemia
This input is used for staging
Description
Anemia is defined by a deficiency of red blood cells or of hemoglobin in the blood. In staging of Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia (CLL/SLL), anemia is defined as Hgb <11.0 g/dL. 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 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. See 3955: Derived Rai stage for additional information on the related data items.Rationale
Anemia is a prognostic factor required for staging of Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia (CLL/SLL) in AJCC 8th edition, Chapter 79 *Hodgkin, and Non-Hodgkin Lymphomas*. It is a new data item for cases diagnosed 1/1/2018+.Additional Info
**Source documents:** laboratory results, clinician’s notesNotes
**Note 1:** **Physician Statement** * Physician statement of anemia or Rai Stage can be used to code this data item when no other information is available. * The physician's stated Rai stage always takes priority when there is conflicting information **Note 2:** **Rai Stage Criteria** * Rai stage is only applicable for CLL, in which the bone marrow and/or peripheral blood are involved (primary site C421 for bone marrow, see Hematopoietic Manual, Module 3: PH 5, 6). **Note 3:** **Pretreatment results only** * Record this data item based on a blood test (CBC and differential) performed at diagnosis (pre-treatment) **Note 4:** **Values for Anemia** * Anemia is defined as Hgb <11.0 g/dL and is part of the staging criteria. * Use the cut points listed in the table regardless of the lab’s reference range * A lab value expressed in grams per liter (g/L) is 10 times the same value expressed in g/dL; therefore, the cut point of 11.0 g/dL is equivalent to 110 g/LCoding Guidelines
**1)** **Code 0** when primary Site is C421 AND there is no evidence of anemia * **a.** Physician documentation of Rai Stage 0-II **2)** **Code 1** when primary Site is C421 AND there is evidence of anemia **3)** **Code 5** when primary site is NOT C421 **4)** **Code 6** when primary site is C421, AND anemia is based on a physician’s statement of anemia or a Rai Stage * **a.** Physician states Rai Stage III **5)** **Code 9** when primary site is C421, AND there is no mention of anemiaNAACCR Item
NAACCR #3811Metadata
SSDI| Code | Description |
|---|---|
| 0 | Anemia not present Hgb >=11.0 g/dL Physician states Rai stage 0-II |
| 1 | Anemia present Hgb <11.0 g/dL |
| 5 | Not applicable: Primary site is not C421 |
| 6 | Lab value unknown, physician states patient is anemic Physician states Rai stage III |
| 7 | Test ordered, results not in chart |
| 9 | Not documented in medical record Anemia not assessed or unknown if assessed No Rai stage is documented in the record and there is no documentation of anemia Physician states Rai stage IV and there is no documentation of anemia |