Optimal treatment for various presentations of Hodgkin lymphoma.
| Presentation . | Hgb g/L . | Lymphs x 109/L . | Histology . | Treatment . | Comments . |
|---|---|---|---|---|---|
| Abbreviations: ABVD, doxorubicin, bleomycin, vinblastine and dacarbazine; BEACOPP, bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone and procarbazine; IPFP, International Prognostic Factors Project; cardio, cardiovascular; 2nd ca, second cancer; PFS, progression-free survival; OS, overall survival. | |||||
| WBC x 109/L | Alb g/L | IPFP score | Prognosis | ||
| 23-year-old man left neck, asymptomatic, mediastinal and retroperitoneal nodes 3–4 cm | 134 | 1.8 | Nodular sclerosing | ABVD x 6 | Stage III A low bulk; good prognosis; no no advantage to highly toxic treatment |
| 11.2 | 42 | 1 (male) | PFS = 80% OS = 90% fertility preserved; cardio/2nd ca risks very low | ||
| 46-year-old woman, lumbar pain, night sweats, retroperitoneal and pelvic nodes 3–7 cm, multiple sclerotic lesions lumbar spine + pelvis | 107 | 0.9 | Mixed cellularity | ABVD x 6–8 | Stage IVbone B intermediate prognosis; no advantage to highly toxic treatment |
| 8.7 | 36 | 3 (age, stage, albumin) | PFS = 75% OS = 85%–90% modestly premature menopause likely; cardio/2nd ca risks very low | ||
| 57-year-old man, lumbar pain, night sweats, mediastinal and retroperitoneal nodes 4–6 cm, multiple splenic nodules, marrow positive | 99 | 0.4 | Mixed cellularity | Escalated BEACOPP x 6–8 | Stage IVmarrow B poor prognosis; highly toxic treatment justified but will carry risk of 4%–5 % lethal toxicity |
| 7.9 | 32 | 6 (age, male, stage, Hgb, lymphocytes, albumin) | PFS = 70% OS = 75%–80% sterility; cardio/2nd ca risks substantially increased | ||
| 19-year-old woman, asymptomatic, right neck and mediastinal nodes 3–5 cm | 132 | 1.0 | Nodular sclerosing | ABVD x 4 | Stage II A excellent prognosis; no need for radiation if CR reached after 2 cycles of ABVD |
| 14.2 | 44 | Not Applicable | PFS = 95% OS = 99% fertility preserved; cardio/2nd ca risks very low | ||
| Presentation . | Hgb g/L . | Lymphs x 109/L . | Histology . | Treatment . | Comments . |
|---|---|---|---|---|---|
| Abbreviations: ABVD, doxorubicin, bleomycin, vinblastine and dacarbazine; BEACOPP, bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone and procarbazine; IPFP, International Prognostic Factors Project; cardio, cardiovascular; 2nd ca, second cancer; PFS, progression-free survival; OS, overall survival. | |||||
| WBC x 109/L | Alb g/L | IPFP score | Prognosis | ||
| 23-year-old man left neck, asymptomatic, mediastinal and retroperitoneal nodes 3–4 cm | 134 | 1.8 | Nodular sclerosing | ABVD x 6 | Stage III A low bulk; good prognosis; no no advantage to highly toxic treatment |
| 11.2 | 42 | 1 (male) | PFS = 80% OS = 90% fertility preserved; cardio/2nd ca risks very low | ||
| 46-year-old woman, lumbar pain, night sweats, retroperitoneal and pelvic nodes 3–7 cm, multiple sclerotic lesions lumbar spine + pelvis | 107 | 0.9 | Mixed cellularity | ABVD x 6–8 | Stage IVbone B intermediate prognosis; no advantage to highly toxic treatment |
| 8.7 | 36 | 3 (age, stage, albumin) | PFS = 75% OS = 85%–90% modestly premature menopause likely; cardio/2nd ca risks very low | ||
| 57-year-old man, lumbar pain, night sweats, mediastinal and retroperitoneal nodes 4–6 cm, multiple splenic nodules, marrow positive | 99 | 0.4 | Mixed cellularity | Escalated BEACOPP x 6–8 | Stage IVmarrow B poor prognosis; highly toxic treatment justified but will carry risk of 4%–5 % lethal toxicity |
| 7.9 | 32 | 6 (age, male, stage, Hgb, lymphocytes, albumin) | PFS = 70% OS = 75%–80% sterility; cardio/2nd ca risks substantially increased | ||
| 19-year-old woman, asymptomatic, right neck and mediastinal nodes 3–5 cm | 132 | 1.0 | Nodular sclerosing | ABVD x 4 | Stage II A excellent prognosis; no need for radiation if CR reached after 2 cycles of ABVD |
| 14.2 | 44 | Not Applicable | PFS = 95% OS = 99% fertility preserved; cardio/2nd ca risks very low | ||