Prognosis
Overall the disease-free survival rate after therapy for HL is as high as 85 - 95%.
Prognosis is based on biological, tumor and treatment factors.
There are no uniform prognostic factors outside of stage and response to therapy across paediatric studies, but there are some other minor factors which may affect outcome.
In Canada between 2000 and 2004, patients aged 0 - 14 years, diagnosed with Hodgkin lymphoma had a 94% 5 year OSP (Observed Survival Proportions).
This was better than patients with non-Hodgkin lymphoma who had a 5 year OSP of 84% (from Canadian Cancer Statistics 2009).
Factors affecting prognosis:
Prognostic Factor |
Favourable |
Unfavourable |
| Stage/Extent of disease | Localized nodal involvement Early stage |
Advanced disease Stage III and IV Extra-nodal extension of disease |
Bulk |
No bulky disease |
Bulky mediastinal or peripheral adenopathy |
Systemic ‘B’ symptoms |
Not present |
Present |
| Response to Chemotherapy | Rapid Early Responder | Slow Early Responder |
Gender (Minor effect) |
Female | Male |
Laboratory studies(In adults CBC appears to affect outcome, but this has not been demonstrated for pediatric studies) |
|
White blood cell count >13,500/microL
Hemoglobin concentration <11.0g/dL |
| Elevated erythrocyte sedimentation rate |
An International Prognostic Score (IPS) was designed by Hasenclever for advanced disease:
The prognostic score was defined as the number of adverse prognostic factors present at diagnosis. Seven factors had independent, adverse prognostic effects:
1) Sex (Male)
2) Age > 45
3) Stage IV
4) HgB < 105
5) WBC > 15
6) Lymphocyte Count < 0.6
7) Albumin < 40
IPS predicts freedom from progression at 5 years
0 factors – 84% (~85%)
1 factor – 77% (~80%)
2 factors – 67% (~70%)
3 factors – 60% (~60%)
4 factors – 51% (~50%)
5 or more factors – 42% (~40%)
External Link:
Prognostic Factors in Childhood and Adolescent Hodgkin Lymphoma at the National Cancer Institute
