Prognostic Score for Advanced Hodgkin Disease

Two-thirds of patients with advanced HD are cured with current approaches to treatment. Prediction of the outcome is important to avoid overtreating some patients and to identify others in whom standard treatment is likely to fail. For these reasons, prediction of the outcome of treatment may allow the identification of patients who are unlikely to have a sustained response to standard treatment.

The following prognostic factors have been found to be independently associated with a poor prognosis by the International Prognostic Factors (IPF) Project in which 5141 patients were evaluated:

1. Serum albumin level <4 g/dL

2. Hemoglobin level <10.5 g/dL

3. Male sex

4. Age greater than 45 years

5. Stage IV disease

6. Leukocytosis (leukocyte count >15,000/mm3)

7. Lymphopenia (absolute lymphocyte count <600/mm3) or lymphocytes <8% of white blood cells.

Each factor was found to add about 8% less tumor-free survival for the group. Use of the IPF data could potentially serve to select patients for more intensive therapy.

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