Predicting the outcome is important to avoid overtreating some patients with Hodgkin's disease, and to identify others in whom standard treatment is likely to fail. Seven factors with similar independent prognostic effects were selected. The prognostic score was then defined as the number of adverse prognostic factors present at diagnosis. The prognostic score was used to predict rates of freedom from progression of disease (panel A) and overall survival (panel B). The panel also presents freedom from progression of disease according to whether the prognostic score was 0-2, 3 or higher.
Definition
Factor |
Log Hazard Ratio |
p |
Relative Risk |
|---|---|---|---|
1. Serum albumin <40 g/l |
0.40 ± 0.10 |
<0.001 |
1.49 |
2. Hemoglobin <105 g/l |
0.30 ± 0.11 |
0.006 |
1.35 |
3. Male sex |
0.30 ± 0.09 |
0.001 |
1.35 |
4. Stage 4 disease |
0.23 ± 0.09 |
0.011 |
1.26 |
5. Age ≥ 45 years |
0.33 ± 0.10 |
0.001 |
1.39 |
6. White blood cells ≥ 15 G/l |
0.34 ± 0.11 |
0.001 |
1.41 |
7. Lymphocytes < 0.6 G/l or <8% of white blood cells |
0.31 ± 0.10 |
0.002 |
1.38 |
Survival curves
Legend A & B
Use of the Prognostic Score to Predict Rates of Overall Survival and Freedom from Progression of Disease in 1618 Patients with Advanced Hodgkin's Disease. The number and percentage of patients with each score were as follows: a score of 0, 115 patients (7 percent); 1, 360 (22 percent); 2, 464 (29 percent); 3, 378 (23 percent); 4, 190 (12 percent); and 5 or higher, 111 (7 percent).
Legend C
Freedom from Progression of Disease in 1618 Patients According to Whether the Prognostic Score Was 0 to 2 or 3 or Higher
Reference:
Hasenclever D, Diehl V, Armitage J, Assouline D, Björkholm M, Brusamolino E et al. A Prognostic Score for Advanced Hodgkin's disease. NEJM 1998 Nov 19; 339(21): 1506-14.Copyright ©2008 Massachusetts Medical Society. All rights reserved.