All are poor prognostic factor for Hodgkins lymphoma except:
Ans: A (Young age) PROGNOSTIC FACTORS Anderson Manual of Medical oncology 2007/248-58 These adverse factors are (1) advanced age, which correlates with the presence of occult abdominal disease and with poor results of salvage therapy; (2) male gender; (3) Mixed cettularity histologic type, which is associated with the presence of occult abdominal disease; (4) B symptoms, also associated with the presence of occult abdominal disease; (5) targe mediastinal mass, defined as a mass measuring greater than one-third the chest diameter on a sta ndard chest radiograph; (6) a larger num ber of involved nodal regions: (7) an elevated erythrocyte sedimentation rate (ESR);(8) anemia; and (9) a low serum albumin level Table (Anderson): Prognostic Classification of the EORTC and GHSG Groups for Clinical Stage l/ll Hodgkin's Lymphoma EORTC Unfavorable (presence of any of the following): Age > 50 year ESR > 50 mm/h without B symptoms, ESR > 30 mm/h with B symptoms Mixed cellularity or lymphocyte depleted type >four nodal sites of involvement Bulky mediastinal involvement GHSG Unfavorable (presence of any of the following): Elevated ESR >three nodal sites of involvement Extra nodal involvement Large mediastinal mass EORTC = European Organization for the Research and Treatment of Cancer: ESR = erythrocyte sedimentation rate; GHSG = German Hodgkin Lymphoma Study Groupi Table: International Prognostic Index for Hodgkin's Lymphoma (Anderson) Hemoglobin < 10.5 g/dL Age >45years^ Male gender Lymphocyte count < 600from3 or < 8% of white blood cell count Serum albumin < 4 g/dL White blood cell count >15,000/mm} Stage IV disease (Ann Arbor system) Recent reports have assessed the prognostic value of biologic markers in Reed-Sternberg and Hodgkin cells. The presence of a higher number of cells expressing topoisomerase II alpha and caspase3 correlates with better patient survival, but BCL-2 expression may predict a poorer patient survival in HL Higher levels of soluble CD3Q also correlate with poorer prognosis. The prognostic significance of CD20 expression by the neoplastic cells of classical HL is controversial. Further investigation is needed to validate these findings
Young age
Involvement of stomach
Lymphocyte depletion
Extranodal metastasis
Hodgkins Lymphoma