Prognostic Factors in Hodgkin’s Disease - Analysis of 211 Patients from a Single Institution.

The treatment adaptation to individual risks of patients with Hodgkin’s disease is closely connected to the prognostic factors identification. The goal of the study was to identify prognostic factors related to survival of patients with Hodgkin’s disease in the population of Plovdiv district (South Bulgaria).

Patients and methods: The retrospective study involved 151 patients with Hodgkin’s disease, diagnosed and treated in the University Clinic of Hematology, Plovdiv, Bulgaria, from 1995 to 2005. The prognostic value of several pretreatment parameters with regard to the survival time was analyzed:

1. Sex,

2. Ann-Arbor clinical staging,

3. ECOG Performance status,

4. Histological type,

5. Extranodal localization,

6. Systemic B symptoms,

7. Abdominal lymphadenopathy and

8. Infradiaphragmatic disease.

The patient’s survival was analyzed by using the Kaplan-Meier method. The log-rank test was used to compare cumulative survival functions.

Results: The mean survival period of patients was 13,35 years (95% C.I. 10,35–16,36). The most important prognostic factors for survival were: ECOG Performance status (P<0,001), Ann-Arbor clinical stages (P=0,0046), extranodal localization (P=0,0009), abdominal lympadenopathy (P=0,0025), B symptoms (P=0,0145) and histological type (P=0,02). The factors with negative impact on survival time were: advanced III/IV clinical stage; poor ECOG performance status 3/4; mixed cellularity/lymphocyte depletion histological type; presence of abdominal lymphadenopathy and B symptoms and more than one extranodal localization. There is a tendency of poorer survival in patients in clinical stage I/II and infradiaphragmatic initial presentation of disease (P=0,185).

Conclusion: Prognostic factors identified in the present study can be easily applied in the routine clinical practice and may be used as a basis for mathematical prognostic models.