Yhim et al reported an model for risk stratification of a patient with primary refractory or relapsed Hodgkin's disease. This can help to identify a patient who may require more aggressive management. The authors are from Princess Margaret Cancer Centre, Jeonbuk National University, University of Toronto, and Dalhousie University.
Patient selection: primary refractory or relapsed Hodgkin's disease
Parameters:
(1) disease status as primary refractory vs relapsed
(2) Deauville Score on PET scan, from 1 to 5
(3) residual tumor volume (rMTV), low or high, with < 4.4 cubic cm defined as low
Parameter
Finding
Points (beta-coefficients)
disease status
relapsed
0
primary refractory
0.817
Deauville and rMTV
DS t to 3
0
DS 4 or 5, low rMTV
0.458
DF 4 or 5, high rMTV
1.551
total score =
= SUM(points for both parameters)
Interpretation:
• minimum score: 0
• maximum score: 2.368
• A high risk patient is more likely to have post-transplant treatment failure.
Total Score
Risk Tertile
0 or 0.458
low
0.817 or 1.276
intermediate
1.551 or 2.368
high
Risk Tertile
Treatment
low
observation after salvage stem cell transplant
intermediate
post-transplant consolidation with novel agents
high
novel treatment strategy
To read more or access our algorithms and calculators, please log in or register.
