Total body computed tomography scan in the initial work-up of Binet stage a chronic lymphocytic leukemia patients: Results of the prospective, multicenter O-CLL1-GISL study

Massimo Gentile, Giovanna Cutrona, Sonia Fabris, Emanuela Anna Pesce, Luca Baldini, Francesco Di Raimondo, Caterina Musolino, Paolo Di Tonno, Nicola Di Renzo, Stefano Molica, Maura Brugiatelli, Fiorella Ilariucci, Simona Zupo, Serena Matis, Francesco Maura, Ernesto Vigna, Francesco Angrilli, Anna Grazia Recchia, Giovanni Quarta, Emilio IannittoAlberto Fragasso, Pellegrino Musto, Mauro Spriano, Iolanda Vincelli, Daniele Vallisa, Agostino Cortelezzi, Francesca Romana Mauro, Robin Foà, Massimo Federico, Antonino Neri, Manlio Ferrarini, Fortunato Morabito

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Abstract

Total body computed tomography (TB-CT) scan is not mandatory in the diagnostic/staging algorithm of chronic lymphocytic leukemia (CLL). The aim of this study was to determine the value and prognostic significance of TB-CT scan in early stage CLL patients. Baseline TB-CT scan was performed in 240 Binet stage A CLL patients (179 Rai low- and 61 Rai intermediate-risk) included in a prospective multicenter observational study (clinicaltrial.gov ID:NCT00917549). The cohort included 69 clinical monoclonal B lymphocytosis (cMBLs). Patients were restaged considering only radiological data. Following TB-CT scans, 20% of cases reclassified as radiologic Binet (r-Binet) stage B. r-Binet B patients showed a higher incidence of unfavorable cytogenetic abnormalities (P = 0.027), as well as a shorter PFS (P = 0.001). At multivariate analysis, r-Binet stage [HR = 2.48; P = 0.004] and IGHV mutational status [HR = 3.01; P = 0.002] retained an independent predictive value for PFS. Among 179 Rai low-risk cases, 100 were redefined as r-Rai intermediate-risk based upon TB-CT scan data, showing a higher rate of cases with higher ZAP-70 (P = 0.033) and CD38 expression (P = 0.029) and β2-microglobulin levels (P

Original languageEnglish
Pages (from-to)539-544
Number of pages6
JournalAmerican Journal of Hematology
Volume88
Issue number7
DOIs
Publication statusPublished - Jul 2013

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ASJC Scopus subject areas

  • Hematology

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Gentile, M., Cutrona, G., Fabris, S., Pesce, E. A., Baldini, L., Di Raimondo, F., Musolino, C., Di Tonno, P., Di Renzo, N., Molica, S., Brugiatelli, M., Ilariucci, F., Zupo, S., Matis, S., Maura, F., Vigna, E., Angrilli, F., Recchia, A. G., Quarta, G., ... Morabito, F. (2013). Total body computed tomography scan in the initial work-up of Binet stage a chronic lymphocytic leukemia patients: Results of the prospective, multicenter O-CLL1-GISL study. American Journal of Hematology, 88(7), 539-544. https://doi.org/10.1002/ajh.23448