Feasibility Study Of Application Of International Prognostic Score On Prediction Of Prognosis For Advanced Hodgkin's Lymphoma

BACKGROUNG & OBJECTIVE:Currently,60%patients with advanced Hodgkin's lymphoma could be cured by receiving standard treatments.The international prognostic factor project on advanced Hodgkin's lymphoma has developed a concept of international prognostic score(IPS) based on seven adverse prognostic factors consisting of male sex,age 45 years or older, stageⅣdisease,leukocytosis,lymphocytopenia,low hemoglobin and low serum albumin for newly diagnosed advanced Hodgkin's lymphoma patients.This study aimed to explore the feasibility of the international prognostic score in advanced Hodgkin's lymphoma.METHODS:We performed a retrospective review of 95 patients with untreated advanced Hodgkin's lymphoma in Cancer Center of Chinese Academic of Medical Science between January 2001 and December 2003.IPS was defined as the number of adverse prognostic factors presented at diagnosis.The rates of failure free survival(FFS) and overall survival(OS) were estimated using the method of Kaplan-Meier and compared according to IPS by log-rank test. RESULTS:The 5-year FFS and OS for 95 advanced Hodgkin's lymphoma patients were 64.5%,75.3%respectively.Estimated 5-year FFS was91.7%,68.3%,33.3%for patients with 0,1-2,≥3 of the adverse prognostic factors respectively.Estimated 5-year OS was91.7%,74.6%,66.7%for patients with 0,1-2,≥3 of the adverse prognostic factors respectively.The 5-year FFS for low risk patients with IPS=0-2 and high risk patients with IPS≥3 were 72.04%,33.5%respectively(P=0.03);the 5 year OS for patients with IPS=0-2 and IPS≥3 were 77.3%,66.7% respectively(P=0.004).The FFS and OS of the advanced HL patients at high risk treated with ABVD were better than those treated with non-ABVD regime.CONCLUSIONS:The IPS shows good prognostic power in advanced HL.Advanced HL patients treated with non-ABVD have inferior survival than those treated with ABVD,thus we recommend patients to be treated with ABVD or more intensive regimen. High-does chemotherapy combined with stem cell transplantation is a method that worth further study that treat patients with advanced or relapsed HL with adverse prognosis.