Hematology Unit, Department of Onco-Hematology, A.O. of Cosenza, Cosenza, Italy.
SS Molecular Diagnostics IRCCS S. Martino-IST, Genova, Italy.
Eur J Haematol. 2016 Jan;96(1):36-45. doi: 10.1111/ejh.12545. Epub 2015 Mar 31.
We performed an external and multicentric validation of the predictive value of abdominal computed tomography (aCT) on time to first treatment (TTFT) in early stage chronic lymphocytic leukemia (CLL) patients.
aCT was performed at diagnosis in 181 Rai 0 patients enrolled in the O-CLL1-GISL trial (clinicaltrial.gov ID:NCT00917549).
Fifty-five patients showed an abnormal aCT. Patients with an abnormal aCT showed a significantly shorter TTFT than those with normal aCT (P < 0.0001). At multivariate analysis, aCT (P = 0.011), β-2 microglobulin (P = 0.019), and CD38 expression (P = 0.047) correlated with TTFT. Following IWCLL 2008 criteria, 112 (61.9%) cases remained at Rai 0, while 69 (38.1%) satisfied the criteria of clinical monoclonal B-cell lymphocytosis (cMBL). Reclassified Rai 0 patients with an abnormal aCT showed a significantly shorter TTFT than those with a normal aCT (P < 0.0001). At multivariate analysis, only aCT (P = 0.011) correlated with TTFT. Eleven cMBL cases (15.9%) showed an abnormal aCT and were reclassified as small lymphocytic lymphomas (SLL); nonetheless, TTFT was similar for cMBLs and SLLs.
Our results confirm the ability of the abnormal aCT to predict progression in early stage cases.
我们对腹部计算机断层扫描（aCT）在早期慢性淋巴细胞白血病（CLL）患者首次治疗时间（TTFT）中的预测价值进行了外部和多中心验证。
在 O-CLL1-GISL 试验（clinicaltrial.gov ID：NCT00917549）中，对 181 例 Rai 0 期患者进行了诊断时的 aCT 检查。
55 例患者的 aCT 异常。与正常 aCT 的患者相比，异常 aCT 的患者 TTFT 明显更短（P<0.0001）。多变量分析显示，aCT（P=0.011）、β-2 微球蛋白（P=0.019）和 CD38 表达（P=0.047）与 TTFT 相关。根据 IWCLL 2008 标准，112 例（61.9%）患者仍为 Rai 0 期，而 69 例（38.1%）符合临床单克隆 B 细胞淋巴细胞增多症（cMBL）标准。重新分类的 Rai 0 期伴异常 aCT 的患者 TTFT 明显短于正常 aCT（P<0.0001）。多变量分析显示，仅 aCT（P=0.011）与 TTFT 相关。11 例 cMBL 病例（15.9%）的 aCT 异常，重新分类为小淋巴细胞淋巴瘤（SLL）；然而，cMBL 和 SLL 的 TTFT 相似。
我们的结果证实了异常 aCT 能够预测早期病例的进展。
