Prognostic factors in high and intermediate grade non-Hodgkin's lymphoma

Abstract

Summary An analysis of prognostic factors has been performed on 260 patients with high and intermediate grade non-Hodgkin's lymphoma (NHL) treated over an 11-year period between 1975 and 1986. The overall 5-year survival rate was 50% with a median follow-up of 72 months. Over 20 clinical, radiological and laboratory parameters have been studied, including variables reported to be important indicators of prognosis in previous series, and these variables have been subjected to univariate and multivariate analysis. Attainment of complete remission (CR) was the most important predictor of overall survival, low serum lactate dehydrogenase (LDH), limited stage disease and a high serum albumin were also independently associated with prolonged survival in multivariate analysis. After removing remission status from the model, Ann Arbor clinical stage became the most significant pre-treatment prognostic indicator. Sixty-five per cent of patients achieved CR, and a discriminant analysis showed that failure to attain CR was associated with advanced stage disease, constitutional symptoms, increasing patient age, a lovy serum albumin and the presence of bulk disease. Advanced clinical stage and an elevated serum LDH predicted independently for a poor relapse-free survival, and reduced overall survival following CR. There was no significant correlation between histological subtype in the Kiel classification and prognosis. This study confirms the prognostic significance of remission status and Ann Arbor clinical stage, and illustrates additional factors including serum levels of albumin and LDH, which serve to enhance the pre-treatment prognostic evaluation of patients with unfavourable histology NHL.

A modified scoring of the NCCN‐IPI is more accurate in the elderly and is improved by albumin and β2‐microglobulin

“…Albumin and b 2 -microglobulin are described in the literature as independent prognostic factors in aggressive lymphoma (Steward et al, 1984;Cowan et al, 1989;Johnson et al, 1993). We confirmed the independent negative prognostic impact of low serum albumin and high b 2 -microglobulin in multivariate analyses despite the improved performance of the NCCN-IPI (see Table IV).…”

High-grade Non-Hodgkin's Lymphoma Treated in Northern Norway: Treatment, Outcome, and Prognostic Factors

“…Most publications on treatment and prognosis in NHL are based on selected patient groups (9,10,14,15); trials with strict inclusion criteria or selected treatment groups where patients above the age of 70 have been excluded. Approximately 50% of patients with NHL are over 65 years of age (16).…”

Application of the international prognostic index in a study of chinese patients with non-hodgkin's lymphoma and a high incidence of primary extranodal lymphoma

“…A lthough several studies have attempted to identify prognostic factors for non-Hodgkin's lymphoma (NHL), [1][2][3][4] only the International Prognostic Index (IPI), 5 which is based on data regarding 2031 patients with aggressive histology, has been widely accepted. Five important prognostic factors were identified for the IPI (age, tumor stage, serum lactate dehydrogenease [LDH], performance status, and the number of extranodal sites involved).…”