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Blood. 2011 Feb 10;117(6):1817-21. doi: 10.1182/blood-2010-04-282228. Epub 2010 Dec 7.

Limited clinical relevance of imaging techniques in the follow-up of patients with advanced chronic lymphocytic leukemia: results of a meta-analysis.

Collaborators (432)

Oduncu F, Dreyling M, Forstpointner R, Schneller F, Bogner C, Peschel C, Ringshausen I, Götze K, Goebeler ME, Rückle-Lanz, Ritgen M, Schawitzke A, Heydrich B, Kern K, Böttcher S, Irmer S, Strack U, Borries V, Klima KM, Scholz C, Herold M, Härtwig K, Dürig J, Dührsen U, Müller-Beissenhirtz H, Noppeney R, Schüttrumpf S, Hohloch K, Binder C, Hasenkamp J, Trümper L, Bäsecke J, Rieger M, Witzens-Harig M, Friedrichs B, Rieger K, Uharek L, Kubuschok B, Murawski N, Held G, Zwick C, Pfreundschuh M, Fingerle-Rowson G, Reiser M, Elter T, Eichhorst B, Pallasch C, Hallek M, Borchmann P, Hacker U, Schinkel S, Wieker K, Sökler M, Wolf HH, Scholz C, Eucker J, Staib P, Schlegel F, Kropff M, Kahl C, Hess G, Beck J, Wölfel T, Bokemeyer C, Schilling G, Dierlamm J, Schüler F, Busemann C, Dölken G, Trendelenburg TK, Bühler A, Stilgenbauer S, Viardot A, Greiner J, Zenz T, Gaidzik V, Langer C, Döhner H, Werner I, Dienst A, Habersang K, Härtel N, Leitner A, Kehrer G, Middeke H, Heinisch K, Adorf D, Ismer B, Hering-Schubert C, Jäckle J, Aulmann C, Söllner S, Majunke P, Fuss H, Käfer G, Potenberg J, Dietrich G, Hartung E, Pronath A, Riedhammer FJ, Zehrfeld T, Prümmer O, Gatter J, Meier A, Wattad M, Heit W, Sauer I, Hilgers K, Geissler M, Bauer J, Stein W, Voigtmann R, Natt F, Nickelsen M, Zeis M, Schmitz N, Lange E, Stoltefuss A, Schubert J, Dürk HA, Kloke O, Fauser A, Roemer E, Kraut L, Musch E, Kohl S, Link H, Kirsch JF, Schatz M, Mezger J, Kempf B, Heil G, Derigs HG, Roll C, Kettner E, Dübbers HW, Lutz L, Hentrich M, Hoffmann U, Ibe M, Falge C, Schäfer-Eckart K, Rothmann F, Raghavachar A, Beckmann K, Behringer D, Stauder H, Hempfling C, Matzdorff A, Hähling D, Kaesberger KJ, Mück R, Waladkhani AR, Clemens M, Kraft J, Ehlert T, N N, Schloen A, Sandritter B, Scholz, Diekmann C, Pflüger KH, Hausner G, Fetscher S, Aulitzky W, Brugger W, Frickhofen N, Fuhr, Lange C, Lambertz H, Schulz L, Schmier M, Bentz M, Tauchmann GM, Schmidt M, Meiler J, Sandmann M, Kürschner D, Maier-Bay B, Lindemann W, Diers J, Riemeier-Sievers C, Daun M, Mergenthaler HG, Hiller S, Schirmer V, Kirchner H, Langer W, Günther B, Gassmann W, Franke K, Burghardt F, Abele U, Celikel-Becker D, von Weikersthal LF, Brög G, Hauch U, Heinrich B, Brudler O, Häcker B, Eckart MJ, Bolouri H, Göttler B, Kindler M, Zuchold K, Strohbach F, Plingen ML, Seibt-Jung H, Kirsch A, Herrenberger J, Doering G, von Grünhagen U, Franke H, Weniger J, Kerzel W, Schmalfeld M, Rohrberg R, Hurtz HJ, Gehbauer G, Hahnfeld S, Vehling-Kaiser U, Abenhardt W, Bosse D, Böning L, Schmidt B, Schick HD, Jacobs G, Stauch M, Hoffmann R, Müller S, Hahn M, Freier W, Dietzfelbinger H, Rassmann I, Söling U, Siehl S, Rudolph R, Weinert R, Sauer A, Meyer B, Eschenburg H, Schadeck-Gressel C, Grabenhorst U, Perker M, Otremba B, Reschke D, Hinrichs HF, Zirpel I, Höring E, Respondek M, Köppler H, Heymanns J, Weide R, Hünermund K, Thiel C, Reiber T, Spohn C, Springer G, Fiechtner H, Hübner A, Kurschel E, Weiss J, Schlag R, Schäfer E, Hartwich G, Schmitz S, Steinmetz T, Kim TS, Lerchenmüller C, Wehmeyer J, Laubenstein HP, Rendenbach B, Lebahn H, Kröning H, Uhle R, Balló H, Gaede B, Zumbrink S, Eckert R, Kamp T, Reimann B, Burkhard O, Mittermüller J, Hansen R, Hitz H, Schliesser G, Schmitt HR, Forstbauer H, Grundeis M, Schulze M, Baldus M, Lakner V, Haen M, Müller C, Dörfel S, Göhler T, Welslau M, Achtzehn V, Culmann H, Gerhardt S, Ulshöfer T, Koschuth A, Schmidt P, Müller L, Schneider M, Koniczek K, Porowski P, Glados M, Knoblich J, Ben-Yehuda D, Jäger U, Gaiger A, Schwarzmeier J, Nösslinger T, Schwarzmeier J, Smith M, Patton N, Gibbons S, Bouabdallah R, Gandhi M, Marlton P, Mills T, Angelucci E, Sorano GG, Casula P, Berneman Z, Kohser P, Hudcova-Burgetova A, Machová R, Papajik T, Kubová Z, Fineman R, Mayer J, Doubek M, Brychtova Y, Ciceri F, Caligaris-Cappio F, Crocchiolo R, Dauriac C, Bernard M, Escoffre-Barbe M, Lamy T, Zikesova E, Karban J, Salkova J, Trnený M, Pytlik R, Tiley C, Forsyth C, Vokurka S, Koza V, Van Hoof A, Selleslag D, Sebban C, Baker B, Belada D, Jebavy L, Smolej L, Pavel Z, Di Ianni M, Castaigne S, Del Poeta G, Amadori S, Catalano J, Ganju V, Hertzberg M, Laurenti L, Dalseg AM, Bron D, Morton J, Durrant S, Casado LF, Theunissen K, Atias D, Berkhan L, Seymour J, Wolf M, Bosly A, Osma Cordoba MM, Portois C, Jaubert J, Ferrant A, Lambert C, Maerevoet E, Van den Neste E, Gadeberg O, Carney B, Cannell P, Eghbali H, Legouffe E, Bordessoule D, Chaury M, Moreau S, Pierri I, Gobbi M, Berrebi A, Lishner M, Yerushazim R, Yermiaku T, Kosolov V, Ambrosetti A, Andreoli AL, Huguet F, Laurent G, Orsucci L, Forconi F, Musuraca G, Zinzani PL, Loscertales J, McQuillan A, Cordingley F, Leahy M, Cazin B, Taylor, Mulligan S, Herbrecht, Cull G, Seldon M, Rowlings P, Ludwig H, Zojer N, Solal-Céligny P, Pomponi F, Savdkova L, Kozák T, Christiansen I, Pérez I, Campbell P, Canales Albendea M, De Paz R, Arthur C, Gisselbrecht C.

Author information

  • 1Department I of Internal Medicine, Centre of Integrated Oncology Köln Bonn, University of Cologne, Cologne, Germany. barbara.eichhorst@uk-koeln.de

Abstract

The clinical value of imaging is well established for the follow-up of many lymphoid malignancies but not for chronic lymphocytic leukemia (CLL). A meta-analysis was performed with the dataset of 3 German CLL Study Group phase 3 trials (CLL4, CLL5, and CLL8) that included 1372 patients receiving first-line therapy for CLL. Response as well as progression during follow-up was reassessed according to the National Cancer Institute Working Group1996 criteria. A total of 481 events were counted as progressive disease during treatment or follow-up. Of these, 372 progressions (77%) were detected by clinical symptoms or blood counts. Computed tomography (CT) scans or ultrasound were relevant in 44 and 29 cases (9% and 6%), respectively. The decision for relapse treatment was determined by CT scan or ultrasound results in only 2 of 176 patients (1%). CT scan results had an impact on the prognosis of patients in complete remission only after the administration of conventional chemotherapy but not after chemoimmunotherapy. In conclusion, physical examination and blood count remain the methods of choice for staging and clinical follow-up of patients with CLL as recommended by the International Workshop on Chronic Lymphocytic Leukemia 2008 guidelines. These trials are registered at http://www.isrctn.org as ISRCTN 75653261 and ISRCTN 36294212 and at http://www.clinicaltrials.gov as NCT00281918.

PMID:
21139079
[PubMed - indexed for MEDLINE]
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