Pretreatment evaluation of patients with CLL
| Diagnostic test . | Section of guidelines . | General practice* . | Clinical trial . |
|---|---|---|---|
| Tests to establish the diagnosis | 1 | ||
| Complete blood count and differential count | 1.1 | Always | Always |
| Immunophenotyping of lymphocytes | 1.2 | Always | Always |
| Assessment before treatment | 3.5.1 | ||
| History and physical, performance status | 3.5.1.1, 3.5.1.2 | Always | Always |
| Complete blood count and differential | 3.5.1.3 | Always | Always |
| Marrow aspirate and biopsy | 3.5.1.4 | Desirable | Desirable |
| Serum chemistry, serum immunoglobulin, direct antiglobulin test | 3.5.1.5, 3.5.1.6, 3.5.1.7 | Always | Always |
| Chest radiograph | 3.5.1.8 | Always | Always |
| Infectious disease status | 3.3 | Always | Always |
| Additional tests before treatment | 3.5.2 | ||
| Cytogenetics (FISH) for del(13q), del(11q), del(17p), trisomy 12, del(6q) in the peripheral blood lymphocytes | 3.5.2.1 | Desirable | Always |
| IgVH mutational status, ZAP-70, and CD38 | 1.2 | NGI | Always |
| CT scan of chest, abdomen, and pelvis | 3.5.2.2 | NGI | Desirable |
| MRI, lymphangiogram, gallium scan, PET scans | 3.5.2.3 | NGI | NGI |
| Abdominal ultrasound* | 3.5.2.4 | Possible | NGI |
| Diagnostic test . | Section of guidelines . | General practice* . | Clinical trial . |
|---|---|---|---|
| Tests to establish the diagnosis | 1 | ||
| Complete blood count and differential count | 1.1 | Always | Always |
| Immunophenotyping of lymphocytes | 1.2 | Always | Always |
| Assessment before treatment | 3.5.1 | ||
| History and physical, performance status | 3.5.1.1, 3.5.1.2 | Always | Always |
| Complete blood count and differential | 3.5.1.3 | Always | Always |
| Marrow aspirate and biopsy | 3.5.1.4 | Desirable | Desirable |
| Serum chemistry, serum immunoglobulin, direct antiglobulin test | 3.5.1.5, 3.5.1.6, 3.5.1.7 | Always | Always |
| Chest radiograph | 3.5.1.8 | Always | Always |
| Infectious disease status | 3.3 | Always | Always |
| Additional tests before treatment | 3.5.2 | ||
| Cytogenetics (FISH) for del(13q), del(11q), del(17p), trisomy 12, del(6q) in the peripheral blood lymphocytes | 3.5.2.1 | Desirable | Always |
| IgVH mutational status, ZAP-70, and CD38 | 1.2 | NGI | Always |
| CT scan of chest, abdomen, and pelvis | 3.5.2.2 | NGI | Desirable |
| MRI, lymphangiogram, gallium scan, PET scans | 3.5.2.3 | NGI | NGI |
| Abdominal ultrasound* | 3.5.2.4 | Possible | NGI |
General practice is defined as the use of accepted treatment options for a patient with CLL who is not enrolled in a clinical trial.
NGI indicates not generally indicated; RQ, research question; PBS, peripheral blood smear; MRI, magnetic resonance imaging; PET, positron emission tomography; and FISH, fluorescence in situ hybridization.
Used in some countries to monitor lymphadenopathy and organomegaly.