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Memorial Sloan Kettering Cancer Center Predictive Model for Advanced Diffuse Histiocytic Lymphoma

Description

Danieu et al separated patients with diffuse histiocytic lymphoma into prognostic groups based on serum LDH levels and the sites of tumor involvement. This can help identify patients who may benefit from more aggressive therapy, and can aid in the interpretation of a treatment effectiveness. The authors are from Memorial Sloan-Kettering Cancer Center in New York.


 

Parameters:

(1) serum LDH

(2) level of site involvement (LSI)

 

Parameter

Finding

Group

serum LDH

< 225 U/L

low

 

225 – 500 U/L

medium

 

> 500 U/L

high

level of site involvement

peripheral lymph nodes +/- Waldeyer ring involvement +/- spleen

I

 

extranodal disease +/- peripheral lymph nodes

II

 

retroperitoneal lymph nodes +/- peripheral lymph nodes

III

 

bulky mediastinal disease +/- any other disease group

IV

 

extranodal disease + retroperitoneal lymph nodes +/- peripheral lymph nodes

V

 

where:

• The LDH was done as part of an SMA-12. The upper limit of the normal reference range for LDH was 225 U/L.

LDH

LSI

Stage

Alive at 48 Months

low

any

I

80%

medium

Group I or II

II

50%

high

Group I or II

III

35%

medium

Group III, IV or V

III

35%

high

Group III, IV or V

IV

15%

 

Limitations:

• The survival in patients has probably improved since 1986, but the relative severity of disease should still be relevant.

 


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