Hodgkin's Lymphoma Stage Four Prognosis

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Also known as Hodgkin's disease, Hodgkin's lymphoma (HL) is a cancer of the white blood cells, or lymphocytes. Characterized by swelling in the lymph nodes, HL is most frequently treated with chemotherapy, especially in its later, more advanced stages.

Like many cancers, the spread of Hodgkin's lymphoma can be measured on a scale of four stages, with Stage I being least severe and Stage 4 being most. The following are characteristics of the four stages:

  • Stage I involves only a single lymph node, generally in the neck region, or one site outside the lymphatic system. It and Stage II can sometimes be treated with radiation therapy alone.
  • Stage II is the involvement of two or more nodes on the same side of the diaphragm.
  • Stage III has nodal involvement on both sides of the diaphragm, with possible involvement of the spleen.
  • Stage IV, the most serious phase of the disease, finds cancerous involvement of widespread extralymphatic organs (i.e., organs outside the system of lymph nodes).

While a diagnosis of Stage IV Hodgkin's lymphoma is a very serious diagnosis, HL remains one of the most treatable of cancers. It responds well to treatment, whether radiation or chemotherapy. About 60 percent of Stage IV patients will be cured of the disease.

Using the staging of the disease is not, however, always a reliable method of assessing survivability. An international effort in 1998 produced a list of seven factors that are intended to provide a more accurate measure of an individual person's likelihood of responding to treatment.

The scale is based on five-year freedom from progression (FFP), or the percentage of patients whose disease has been successfully halted within five years. Patients with zero factors have an 84 percent FFP. Each of the following factors reduces the 5-year FFP by seven percent:

  • Age greater than 44 years
  • Stage IV
  • Hemoglobin less than 10.5 g/dl
  • Lymphocyte count less than eight percent
  • Patient is male
  • Albumin less than 4.0 g/dl
  • White blood count of 15,000 per microlitre or higher

The reliability of the criteria declines with more than five factors, so for five or more factors, the 5-year FFP is said to be 42 percent.

The Hodgkin's lymphoma Stage IV prognosis is therefore reasonably positive. As one of the "best" cancers to have, Hodgkin's lymphoma is less likely to pose a threat to a patient's life, even in its more advanced stages, than many other diseases.

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