Blum KA et al. (2007) Computed tomography scans do not improve the predictive power of 1996 National Cancer Institute-sponsored Working Group chronic lymphocytic leukemia response criteria. J Clin Oncol 25: 5624–5629

The 1996 National Cancer Institute-sponsored Working Group (NCI-WG) response criteria for chronic lymphocytic leukemia (CLL) specify performance of a complete blood count, physical examination and bone marrow evaluation, but they do not recommend CT scans as standard. CT scans are incorporated into the response criteria of other hematologic malignancies such as non-Hodgkin's lymphoma (NHL), but the benefit of CT-measured lymph node response in predicting patient outcomes in CLL remains unclear.

A retrospective study by Blum et al. has compared the response determinations of the NCI-WG CLL criteria with those of the NHL-CT response criteria, in 82 patients with CLL treated at Ohio State University. The NCI-WG CLL criteria identified 5 complete responses, 32 partial responses, 21 cases of stable disease, and 17 cases of progressive disease. The NHL-CT criteria documented 3 patients with complete response, 16 patients with partial response, 26 patients with stable disease, and 17 patients with progressive disease. The progression-free survival times (PFSs) of patients classified as having complete or partial responses according to the NCI-WG criteria were 27.3 months and 11.4 months, respectively, whereas patients classified as having a complete or partial response in accordance with NHL-CT criteria had PFSs of 18.4 months and 14.5 months, respectively.

By log-rank test, NCI-WG CLL response significantly correlated with PFS and overall survival (P <0.001 and P = 0.012, respectively). NHL-CT response also correlated with PFS and overall survival (P <0.001 for both). In multivariate analysis, both NCI-WG CLL and NHL-CT response significantly predicted PFS (P = 0.009 and P = 0.001, respectively). These data do not demonstrate any additional benefit from the use of CT scans in response evaluation of patients with CLL.