stage 4 hodgkin's lymphoma | Prognosis and survival for Hodgkin's lymphoma

Prognosis and survival for Hodgkin's lymphoma




If you have a Hodgkin's lymphoma (LH), you may be asking questions about your prognosis. The prognosis is the act by which the Doctor best evaluates how the cancer will affect a person and how he would react to treatment. Prognosis and survival depend on many factors. Only a doctor who is familiar with your medical history, the type, stage and characteristics of the cancer you are diagnosed with, the treatments selected and the treatment response can examine all of these data in conjunction with the survival statistics To come up with a prognosis.

A prognostic factor is an aspect of cancer or a characteristic of the person who is affected by the physician when making a prognosis. A predictive factor influences how cancer responds to a given treatment. Prognostic factors and predictive factors are often approached together. Both play a role in the choice of the treatment plan and in the prognosis setting.

The LH stage is an important factor when a prognosis is formulated and the treatment is planned. However, the extent of LH propagation and the organs or regions of affected tissues may vary within the same stage. Physicians therefore rely on the following factors to estimate the prognosis of early or advanced LH. These risk factors are referred to as adverse, or negative, factors as they increase the risk of LH reappearing (recurrence) after being treated.

Early LH
Stage 1 or 2 LH is considered to be precocious. Based on the following risk factors, physicians determine whether early LH is favorable or unfavourable:

Early LH is favorable if none of these risk factors are present.
Early LH is unfavourable if one or more of these risk factors are present.
Symptoms B
If a person does not have a symptom B, the doctors add the letter a after the stage. If she experiences it, they add the letter B. Early LH therefore includes stages 1a, 1b and 2a.

B symptoms include:

Unexplained fever greater than or equal to 38 °c
Abundant night sweats
Unexplained weight loss equal to more than 10% of body weight over the previous 6 months
Tumor Volume
Large tumours often produce a less favorable prognosis than small tumours, as they tend to react less well to treatment. Doctors may consider the following tumors as voluminous:

Chest tumor measuring at least one third of the width of the thorax
Tumor located in another region of the body measuring at least 10 cm in diameter
Spread to areas outside the lymph nodes
The prognosis of LH is more favorable if confined in the lymph nodes than if it has spread to other organs or regions of the body such as bone marrow, liver or lungs. (Doctors can give the names of extraganglionnaires seats to the affected areas outside the lymph nodes.)

Propagation to multiple regions ganglion
The prognosis of LH is less favourable if 3 or more ganglion regions are reached.

Globular sedimentation velocity (VSG)

The following globular sedimentation velocities (VSG) are adverse risk factors:

VSG greater than or equal to 50 mm/h in persons who do not experience symptoms B

VSG greater than or equal to 30 mm/h in persons experiencing symptoms B

Advanced LH

Advanced LH includes Stages 2b (associated with the presence of B symptoms), 3 and 4. The International Prognostic Factors Project (Pips) has developed an international prognostic Index (IPI) for advanced LH. This is based on the following 7 adverse (or negative) risk factors.

Advanced LH is favorable if 3 of these factors or less are present.

Advanced LH is unfavourable if 4 of these or more factors are present.

Stage 4

The prognosis of Stage 4 LH is less favorable than that of stage 2b or 3 LH.

Age

The prognosis of people aged 45 years or older is less favourable.

Male

The prognosis of men is less favorable than that of women.

Low levels of hemoglobin

A hemoglobin level of less than 105 g/L is an adverse factor.

Low albumin

An albumin level less than 40 g/L is an unfavourable factor.

High number of white blood cells

A number of white blood cells greater than or equal to 15 000/mm3 is an adverse factor.

Low number of lymphocytes

A number of lymphocytes less than 600/mm3 or representing less than 8% of the total number of white blood cells is an adverse factor.