Patients with aggressive non-Hodgkin's lymphoma have varying clinical courses. The presence of certain adverse factors can help identify those with a worse prognosis, and in whom more intensive therapy may be indicated initially.
Four prognostic factors:
(1) serum LDH
(2) Ann Arbor stage
(3) number of extranodal sites
(4) tumoral mass
These were found to correlate with:
(1) overall survival
(2) response to treatment
(3) relapse
(4) freedom from relapse survival
Prognostic Factors
Not Adverse
Adverse
LDH level
normal
increased
Ann Arbor stage
I or II (localized disease)
III or IV
number of extranodal sites
0 or 1
>= 2
tumoral mass
< 10 cm
>= 10 cm
Prognostic Group
Features
good
no adverse factors present
intermediate
normal LDH + 1 adverse factor present
normal LDH + 2 adverse factors present
increased LDH + no other adverse factors present
poor
normal LDH + 3 other adverse factors present
increased LDH + at least one other adverse factor present
Additional parameters associated with short overall survival:
(1) impaired performance status (ECOG status >=2)
(2) weight loss >= 10%
(3) low serum albumin (<= 3 g/dL)
(4) bone marrow involvement
(5) age > 65 years
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