Baseline evaluation of patients with CLL
| Diagnostic test . | General practice . | Clinical trial . |
|---|---|---|
| Tests to establish the diagnosis | ||
| CBC and differential count | Always | Always |
| Immunophenotyping of peripheral blood lymphocytes | Always | Always |
| Assessment before treatment | ||
| History and physical, performance status | Always | Always |
| CBC and differential count | Always | Always |
| Marrow aspirate and biopsy | When clinically indicated (unclear cytopenia) | Desirable |
| Serum chemistry, serum immunoglobulin, and direct antiglobulin test | Always | Always |
| Chest radiograph | Always | Always |
| Infectious disease status | Always | Always |
| Additional tests before treatment | ||
| Molecular cytogenetics (FISH) for del(13q), del(11q), del(17p), add(12) in peripheral blood lymphocytes | Always | Always |
| Conventional karyotyping in peripheral blood lymphocytes (with specific stimulation) | NGI* | Desirable |
| TP53 mutation | Always | Always |
| IGHV mutational status | Always | Always |
| Serum β2-microglobulin | Desirable | Always |
| CT scan of chest, abdomen, and pelvis | NGI | Desirable |
| MRI, PET scans | NGI | NGI |
| Abdominal ultrasound† | Possible | NGI |
| Diagnostic test . | General practice . | Clinical trial . |
|---|---|---|
| Tests to establish the diagnosis | ||
| CBC and differential count | Always | Always |
| Immunophenotyping of peripheral blood lymphocytes | Always | Always |
| Assessment before treatment | ||
| History and physical, performance status | Always | Always |
| CBC and differential count | Always | Always |
| Marrow aspirate and biopsy | When clinically indicated (unclear cytopenia) | Desirable |
| Serum chemistry, serum immunoglobulin, and direct antiglobulin test | Always | Always |
| Chest radiograph | Always | Always |
| Infectious disease status | Always | Always |
| Additional tests before treatment | ||
| Molecular cytogenetics (FISH) for del(13q), del(11q), del(17p), add(12) in peripheral blood lymphocytes | Always | Always |
| Conventional karyotyping in peripheral blood lymphocytes (with specific stimulation) | NGI* | Desirable |
| TP53 mutation | Always | Always |
| IGHV mutational status | Always | Always |
| Serum β2-microglobulin | Desirable | Always |
| CT scan of chest, abdomen, and pelvis | NGI | Desirable |
| MRI, PET scans | NGI | NGI |
| Abdominal ultrasound† | Possible | NGI |
General practice is defined as the use of accepted treatment options for a CLL patient not enrolled on a clinical trial.
CBC, complete blood count; MRI, magnetic resonance imaging; NGI, not generally indicated; PET, positron emission tomography.
Conventional karyotyping in peripheral blood lymphocytes (with specific stimulation) may be useful before therapy, if established methodology is available.
Used in some countries to monitor lymphadenopathy and organomegaly.