Survival for Hodgkin's lymphoma (HL) has improved significantly in the past 50 years. This is due to effective chemotherapy regimens and improved use of radiation therapy, as well as more accurate staging procedures ensuring allocation to correct treatment groups.
Prognostic factors for early stage disease (stage I-IIA)
Based on data from multiple studies, the following risk factors are prognostically unfavorable:
- ESR > 50
- > 2 lymph node stations involved
- Disease below the diaphragm (with the exception of unilateral inguinal involvement)
- Lymphocyte-poor histology
- Bulky disease (Diameter ≥ 10 cm)
Prognostic factors for advanced disease (stage IIB-IV). International Prognostic Score (IPS).
Based on a multicenter study of prognostic variables in patients who have received "state of the art" chemotherapy, it is possible to confirm the following seven factors as independent unfavorable prognostic factors in multivariate analysis:
- Age > 45 years
- Albumin ≤ 40 g/l
- Hemoglobin < 10.5 g/dl
- Male sex (compared to women sex).
- Stage IV disease
- Leukocytosis ≥ 16 x 109/l
- Lymphopenia < 0.6 x 109/l
The different risk factors contribute almost equally to the patients` overall risk of treatment failure and can therefore be combined.
The survival outlook for HL is currently good with a 5 year survival of almost 90%, and better for patients under 60. There is no difference in survival between the different histological subgroups.
Five-year relative survival for patients with Hodgkin's lymphoma, in percent, during the diagnosis period 1974–2013.
Source: Cancer Registry of Norway