Predictive Equation for Prognosis in Hodgkin's Disease of Gobbi et al

 

Treatment protocol:

(1) stage IA: extended field radiotherapy

(2) stage IIA or IIIA with favorable histologic type (LP, NS): extended field radiotherapy

(3) stage IIA or IIIA with unfavorable histologic type (MC, LD): combined chemoradiotherapy or chemotherapy alone

(4) patients with B symptoms : combined chemoradiotherapy or chemotherapy alone

(5) stage IV: combined chemoradiotherapy or chemotherapy alone

(6) first step chemotherapy regimen: MOPP or COPP

(7) second step chemotherapy regimen: MOPP if at least 2 years had passed since the first regimen

(8) doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD) or MOPP alternating with ABVD were used as salvage therapy

 

Parameters at the time of diagnosis associated with prognosis:

(1) erythrocyte sedimentation rate

(2) age

(3) sex

(4) serum albumin

(5) clinical stage

(6) histologic type of Hodgkin's disease

Parameter	Finding	Score
erythrocyte sedimentation rate (ESR)	<= 45 mm per hr	0
	> 45 mm per hr	1
stage	I or II	0
	III or IV	1
histologic type	lymphocyte predominant (LP), or nodular sclerosing (NS)	0
	mixed cellularity (MC), or lymphocyte depleted (LD)	1
age	< 45 years	0
	>= 45 years	1
albumin	<= 3.5 g/dL	1
	> 3.5 g/dL	0
sex	male	1
	female	0

 

expected mean survival time in months =

= 329.5 - (64 * (ESR score)) - (70.6 * (stage score)) - (60.2 * (histologic type score)) - (40.4 * (age score)) - (29.9 * (albumin score)) - (24.3 * (sex score))

 

Interpretation:

• maximum survival by equation (all favorable): 329.5 months (27 years)

• minimum survival by equation (all unfavorable factors): 40.1 months

• 5 year survival with all favorable factors: about 85%

• 5 year survival with all unfavorable factors: 20%

 

Limitations:

• Survival would be affected by treatment protocols, so that patients treated with different protocols or newer agents may have different survivals.