Originally published as JCO Early Release 10.1200/JCO.2006.08.4194 on March 12 2007

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Abdominal Computed Tomography Predicts Progression in Patients With Rai Stage 0 Chronic Lymphocytic Leukemia

Ana Muntañola, Francesc Bosch, Pedro Arguis, Eduardo Arellano-Rodrigo, Carmen Ayuso, Eva Giné, Marta Crespo, Pau Abrisqueta, Carol Moreno, Francesc Cobo, Armando López-Guillermo, Emili Montserrat

From the Departments of Hematology and Radiology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain

Address reprint requests to Emili Montserrat, MD, Department of Hematology, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; e-mail: emontse{at}clinic.ub.es

Purpose Whether computed tomography (CT) should be routinely included in the diagnostic work-up in patients with chronic lymphocytic leukemia (CLL) has not yet been determined. The aim of this study was to analyze the prognostic significance of abdominal CT in patients with CLL in Rai clinical stage 0.

Patients and Methods Abdominal CT was performed at diagnosis in 140 patients consecutively diagnosed with CLL in Rai stage 0 disease.

Results An abnormal abdominal CT was found in 38 patients (27%). Abnormal CT correlated with increased bone marrow infiltration (P = .024), high lymphocyte count (P = .001), increased ZAP-70 expression (P = .003), and short lymphocyte doubling time (LDT; P = .007). Patients with abnormal CT progressed more frequently and had a shorter time to progression than those with normal CT (median, 3.5 years v not reached, respectively; P < .001) and required earlier treatment intervention. In a multivariate analysis, only high ZAP-70 expression (relative risk = 3.60) and an abnormal abdominal CT (RR = 2.71) correlated with disease progression.

Conclusion In this series, an abnormal abdominal CT was a strong predictor of progression in patients with early-stage CLL. The inclusion of CT scans in the initial work-up of patients with early clinical stage on clinical grounds can, therefore, provide relevant clinical information.

published online ahead of print at www.jco.org on March 12, 2007.

Supported by grants from the Spanish Ministry of Health (05/0213), Marató de TV3 (05/1810), Deutsche José Carreras Leukämie-Stiftunge (D-1643), and Red Temática de Investigación Cooperativa en Cáncer (RTICC) 2006. A.M. holds a contract from Asociación Española contra el Cáncer.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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