Favorable Prognostic Factors for Malignant Lymphomas
| |
Hodgkin Lymphoma |
Non-Hodgkin Lymphoma |
| Stage |
Early stage |
Early stage |
| Symptoms |
Asymptomatic |
Good performance score (Karnofsky) |
| Age at Dx |
Young |
Age < 60 |
| Other |
Long remission |
1 or fewer extranodal
sites; normal LDH |
Hodgkin Lymphoma (Adult)
Prognostic factors
Cell type (in order from most favorable to least
favorable)--Lymphocyte predominant, Nodular sclerosis,
Mixed cellularity, Lymphocyte depletion.
Presence or absence of "B" symptoms is
an important prognostic indicator as are the presence
of large masses, involvement of the spleen, and the
absolute number of nodal sites of involvement.
Hodgkin lymphoma may be cured with chemotherapy,
but the incidence of secondary acute nonlymphocytic
leukemia within 10 years is more than 3%. The risk
of subsequent solid tumor primaries is about 13%
at 15 years.
Five year Disease Free Survival Rates
(from the National Cancer Institute's Physician
Data Query System, July 2003)
| Stage I |
up to 90% |
| Stage II |
78 - 90% |
| Stage IIIA |
60 - 78% |
| Stage IIIB |
50 - 60% |
| Stage IV |
40 - 50% |
Non-Hodgkin Lymphoma (Adult)
Prognostic factors
| Better |
Worse |
nodular
|
diffuse |
small lymphocytic
|
large cell |
extensive fibrosis
|
minimal fibrosis |
| Asymptomatic |
B symptoms |
| Age--young |
Age--older |
| Small mass |
Bulky disease (mass > 10 cm) |
| No extranodal involvement |
GI or bone marrow involvement |
Five Year Disease Free Survival Rates for Working
Formulation Cell Types (all stages)
from Manual for Clinical Oncology, second edition,
DA Casciato and BB Lowitz, Little Brown and Co., 1990)
| Low Grade |
| A. |
Small lymphocytic |
59% |
| B. |
Follicular small cleaved cell |
70% |
| C. |
Follicular mixed |
50% |
| Intermediate Grade |
| D. |
Follicular large cell |
45% |
| E. |
Diffuse small cleaved cell |
33% |
| F. |
Diffuse mixed small and large cell |
38% |
| G. |
Diffuse large cell |
35% |
| High Grade |
| H. |
Immunoblastic large cell |
32% |
| I. |
Lymphoblastic |
26% |
| J. |
Small noncleaved cell |
23% |
