Non-Hodgkin Lymphomas: Prognostic Features

· Age

· > 60 y worse prognosis

· > 40 y worse prognosis for low-grade NHL

· Sex

· Male worse prognosis in low-grade NHL (multivariate analysis)

· Correlated with adverse prognostic factors (histologic type, stage, and symptoms) in NHL

· B symptoms: worse prognosis (multivariate)

· Fever > 38.5

· Unexplained weight loss (> 10%)

· Drenching night sweats

· Correlates with extent of disease but also effect independent of stage

· Performance status

· Overall activity level

· Range from fully active to bed-ridden

· Less than fully active or fully ambulatory is worse prognosis

· Serum levels

· LDH elevated is worse prognosis

· Correlates with tumour burden but also independent effect

· Tumour bulk

· Usually defined by clinical means

· > 5-10 cm diameter has higher rates of relapse of stage I or II treated with radiotherapy

· > 10 cm diameter has poor outcome in stage III and IV treated with chemotherapy

· Poor outcome in stage II to IV:

· Large mediastinal mass (> 1/3 of chest diameter)

· Palpable abdominal mass

· Combination of para-aortic and pelvic node involvement

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