Unfavorable prognostic factors in early (stage I/II) Hodgkin lymphoma
Unfavorable prognostic factors in early (stage I/II) Hodgkin lymphoma
European Organization for the Research and Treatment of Cancer (EORTC)
Large mediastinal adenopathy (>1/3 maximum transverse thoracic diameter)
Involvement of four or more lymph node regions
Age ≥50 years at diagnosis
A defined combination of B symptoms* and elevated ESR: B symptoms and an ESR over 30 mm/hour or an ESR over 50 mm/hour without B symptoms
German Hodgkin's Study Group (GHSG)
Large mediastinal adenopathy (>1/3 maximum transverse thoracic diameter)
Three or more lymph node sites of involvement
A defined combination of B symptoms and elevated ESR: B symptoms and an ESR over 30 mm/hour; an ESR over 50 mm/hour without B symptoms
National Cancer Institute of Canada (NCIC)/Eastern Cooperative Oncology Group (ECOG)
Large mediastinal adenopathy (>1/3 maximum transverse thoracic diameter)
Involvement of four or more sites
Age ≥40 years at diagnosis
ESR >50 mm/hour
Mixed cellularity histology
Once the diagnosis of Hodgkin lymphoma has been established, therapy and prognosis are based upon the stage of the disease. Among patients with stage I-II disease, there is subsequent stratification into favorable and unfavorable prognosis disease based upon the presence or absence of certain clinical features, such as age, B symptoms, and large mediastinal adenopathy. Stratification of patients with early stage disease into favorable and unfavorable subsets varies by region.
ESR: erythrocyte sedimentation rate.
* B symptoms are systemic symptoms of significant unexplained fever, night sweats, or unexplained weight loss exceeding 10% of body weight during the six months prior to diagnosis.