Derived Rai Stage
Description
This data item stores the Derived Rai stage value derived from the values coded in the following related data items for the Lymphoma-CLL/SLL schema (9823/3).
Per confirmation from medical oncologists, Rai stage is only recorded for patients who have bone marrow and/or peripheral blood involvement. Per the Hematopoietic Rules, primary site would be C421 (See [Hematopoietic Manual](https://seer.cancer.gov/tools/heme/Hematopoietic_Instructions_and_Rules.pdf), Module 3: Rules PH 5, 6). Use code 5 for the 5 SSDIs when primary site is not C421.
The Rai classification system is now used to stage chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) (9823/3) when bone marrow and/or peripheral blood are involved using several different criteria. The stages are based on the absence or presence of the following related data items.
* 3885: Lymphocytosis
* 3804: Adenopathy
* 3907: Organomegaly
* 3811: Anemia
* 3933: Thrombocytopenia
**Note: All of these data items are required for Staging for the AJCC Staging System Hodgkin and Non-Hodgkin Lymphomas (9823/3 only) and EOD.**
Rai stages
* Stage 0 CLL is characterized by absolute lymphocytosis (>15,000/mm3) without adenopathy, hepatosplenomegaly, anemia, or thrombocytopenia
* Stage I CLL is characterized by absolute lymphocytosis with lymphadenopathy without hepatosplenomegaly, anemia, or thrombocytopenia
* Stage II CLL is characterized by absolute lymphocytosis with either hepatomegaly or splenomegaly with or without lymphadenopathy
* Stage III CLL is characterized by absolute lymphocytosis and anemia (hemoglobin <11 g/dL) with or without lymphadenopathy, hepatomegaly, or splenomegaly
* Stage IV CLL is characterized by absolute lymphocytosis and thrombocytopenia (<100,000/mm3) with or without lymphadenopathy, hepatomegaly, splenomegaly, or anemia
This table below* can be used when the **ONLY** information available is the documented Rai stage from the managing physician. (Note: The Rai stage cannot be found on a pathology report).
***Please see the Site-Specific Data Item (SSDI) Manual for the table.**
Rationale
The Derived Rai stage can be used to evaluate disease spread at diagnosis, treatment patterns and outcomes over time.
Additional Info
**Source documents:** laboratory results, physical exam, clinician’s notes
Notes
This field should be left blank for all cases diagnosed prior to 2018, for schemas other than 00795, and when not required by standard setter.
Metadata
SSDI
| Rai Code |
Rai Stage |
Description |
| 0 |
0 |
Lymphocytosis |
| 1 |
I |
Lymphocytosis and Adenopathy |
| 2 |
II |
Lymphocytosis and Organomegaly
(Adenopathy is any value other than 5) |
| 3 |
III |
Lymphocytosis and Anemia
(Adenopathy and Organomegaly are any value other than 5) |
| 4 |
IV |
Lymphocytosis and Thrombocytopenia
(Adenopathy, Organomegaly and Anemia are any value other than 5) |
| 8 |
N/A |
Does not apply, primary site not bone marrow (C421)
(All 5 SSDIs should be set to 5) |
| 9 |
9 |
Unknown
(All 5 SSDIs are 9 or blank OR
At least one is set to 9 OR
Lymphocytosis is 0,7,9 OR
Lymphocytosis is blank and one of the other SSDIs is a value other than 5 or 9) |
| <BLANK> |
|
Not Calculated (DCO) |
