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Prognostic Factors

Prognosis is the likely outcome of a disease along with the chance of recovery or recurrence. Hodgkin lymphoma (HL) cases are generally classified into the three subgroups described below.

  • Early-stage favorable: stage I to II with no unfavorable risk factors
  • Early-stage unfavorable: stage I to II with one or more of the following unfavorable risk factors
    • Bulky disease: a mass in the chest that is one-third the width of the chest, or any lymph node mass greater than 10 centimeters
    • Involvement of 3 or more lymph nodes
    • B symptoms: fever, drenching night sweats and/or unexplained weight loss greater than 10 percent of body weight over 6 months
    • Extranodal disease: involvement of an organ outside the lymphatic system
    • Erythrocyte sedimentation rate (ESR) of 50 or higher
  • Advanced stage: stage III to IV
    • Seven factors provide a basis for recommending either aggressive or less-intensive treatment options
      • Being male
      • Age 45 or older
      • Stage IV disease
      • Albumin level below 4 g/dL (grams per deciliter)
      • Hemoglobin level below 10.5 g/dL
      • Leukocytosis: white blood cell count greater than 15,000/uL
      • Lymphocytopenia: lymphocyte count less than 8% of the white blood cell count and/or lymphocyte count less than 600/uL

The International Prognostic Score (IPS) assigns a point for each adverse prognostic factors present at diagnosis. The IPS helps doctors to determine the course of treatment and the prognosis for patients with advanced-stage (stage III to IV) disease.

About 30% of patients present with early-stage favorable HL; the other 70% of patients present with more advanced disease.


Related Links

  • Download or order The Leukemia & Lymphoma Society's free booklet, Hodgkin Lymphoma.