Prognostic factors in Hodgkin's disease

Abstract

The clinical records and treatment results of 163 patients with Hodgkin's disease, who were seen at Ellis Fischel State Cancer Hospital (EFSCH) between 1940 and 1971, were reviewed and analyzed. More than 200 clinical and histological variables were recorded for each case of Hodgkin's disease, including details of radiotherapy and chemotherapy. Statistical studies were carried out in order to evaluate the independent prognosis significance of each of these factors. All of the lesions were reclassified according to the Lukes proposal which was modified and recommended at the 1965 Rye classification (except for hepatomegaly which was included in Stage IV). This is a retrospective study, and the modern techniques of staging were rarely used in pretreatment studies (since 1965, only ten patients have had an abdominal exploration). The basic work-up consisted of a complete blood count, urinalysis, blood type, chest X ray, and EKG. Lymphangiogram and radioisotope liver scans were used on less than 10% of the patients. About 30% of the patients had gastrointestinal X rays and 70% had IVP. Bone marrow biopsies -- the majority of which were done by needle aspiration -- were obtained for approximatley 50% of the patients. Clinical stage, histological type, and presence of absence of systemic symptoms appeared to be themost significant prognostic factors. The classification of systemic symptoms according to the criteria of either the Rye or Ann Arbor conferences showed no particular difference in determining the survival rate. Among the systemic symptoms, fever appeared to be the most important for survival rate. Survival rates were higher in nonanemic and nonlymphocytopenic patients. Eosinophilia, blood group, and Rh factor had no prognostic significance. The relapse-free interval was an important indicator of long-term prognosis. The unfavorable influence of relapse in ultimate prognosis was clearly seen; however, the extent of the relapse site was shown to have no significant influence on survival.

Survival in Hodgkin's disease by stage and age

“…The data substantiate other reports wherein elderly patients with Hodgkin's disease may have a different course than younger patients [6][7][8][9][10][11][12][13][14]. Older patients with advanced Hodgkin's disease have responded less well to chemotherapy, and their health is complicated by medical problems [15].…”

Clinical practice of precision medicine in lymphoma

“…41,42 The well accepted staging system is Ann Arbor staging. 43,44 Each stage is divided into group A and group B (without or with group B symptoms). The symptoms of group B include fever and unexplained body temperature >38 • C; night sweats; weight loss of more than 5 kg within 6 months.…”

“…PET‐CT has a more important role in diagnosis and staging evaluation of HL 41,42 . The well accepted staging system is Ann Arbor staging 43,44 . Each stage is divided into group A and group B (without or with group B symptoms).…”