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
Specialty: Hematology Oncology