Josting et al developed a prognostic score for patients with relapsed Hodgkin's disease. This can help identify patients who may benefit from more aggressive management. The authors are from the University of Cologne and the German Hodgkin's Lymphoma Study Group.
Patient selection: Hodgkin's disease with complete response to chemotherapy
Parameters:
(1) time for relapse after initial therapy
(2) clinical stage at relapse
(3) hemoglobin at relapse
Parameter
Finding
Points
time for relapse
> 12 months
0
<= 12 months
1
clinical stage at relapse
I or II
0
III or IV
1
hemoglobin at relapse
male and >= 12 g/dL
female and >= 10.5 g/dL
0
male and < 12 g/dL
female and < 10.5 g/dL
1
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• The higher the score the worse the prognosis.
The treatment of choice for patients with relapse after chemotherapy is high dose chemotherapy (HDCT) followed by stem cell transplantation. The prognosis is worse if treated with conventional chemotherapy.
Total Score
Prognostic Group (Conventional Salvage)
5 Year Survival after HDCT
0
good
100%
1
moderate
70%
2
poor
46%
3
very poor
50%
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