Straus et al identified prognostic factors associated with poor outcome in patients with advanced Hodgkin's disease. This can help identify patients who may require more aggressive therapy. The authors are from Memorial Sloan-Kettering Cancer Center in New York City.
Parameters for overall survival:
(1) age
(2) hematocrit (anemia)
(3) involvement of inguinal lymph nodes
(4) serum LDH
(5) mediastinal mass
Parameters for rate of disease progression: all 5 of the above plus
(6) bone marrow involvement
|
Parameter |
Finding |
Points |
|
age |
<= 45 years of age |
0 |
|
|
> 45 years of age |
1 |
|
hematocrit (page 1176) |
male gender and hematocrit >= 38% |
0 |
|
|
male gender and hematocrit < 38% |
1 |
|
|
female gender and hematocrit >= 34% |
0 |
|
|
female gender and hematocrit < 34% |
1 |
|
inguinal lymph node involvement |
absent |
0 |
|
|
present |
1 |
|
serum LDH |
<= 400 U/L |
0 |
|
|
> 400 U/L |
1 |
|
mediastinal mass |
absent |
0 |
|
|
diameter <= 0.45 of thoracic diameter |
0 |
|
|
diameter > 0.45 of thoracic diameter |
1 |
|
bone marrow involvement |
absent |
0 |
|
|
present |
1 |
score for overall survival =
= SUM(points for the first 5 parameters)
score for rate of disease progression =
= SUM(points for all 6 parameters)
Interpretation:
• minimum scores: 0
• maximum score for overall survival: 5
• maximum score for rate of disease progression: 6
|
Overall Survival Score |
Prognostic Group |
Therapy Failure |
Survival |
|
0 or 1 |
low risk |
unlikely |
> 95% long term |
|
>= 2 |
high risk |
more likely |
median 62.4 months |
Limitations:
• The method and reference range for LDH was not given.
Specialty: Hematology Oncology
