The International Prognostic Factors Project score for advanced Hodgkin's disease is useful for predicting outcome of autologous hematopoietic stem cell transplantation.
BACKGROUND
The International Prognostic Factors Project on Advanced Hodgkin's Disease developed a seven-factor prognostic score consisting of serum albumin, hemoglobin, gender, stage, age, leukocytosis and lymphocytopenia for newly diagnosed Hodgkin's disease patients who receive chemotherapy. The purpose of this study was to determine whether this prognostic score would also be useful for Hodgkin's disease patients undergoing autologous hematopoietic stem cell transplantation.


METHODS
We performed a retrospective review of 379 patients who had autologous transplants for Hodgkin's disease, at the University of Nebraska Medical Center between October 1984 and December 1999. Multivariate analysis was performed to determine whether the prognostic factors identified by the International Prognostic Factors Project adversely influenced event-free survival (EFS) or overall survival (OS).


RESULTS
Low serum albumin, anemia, age and lymphocytopenia were associated with poorer EFS and OS. Gender, stage and leukocytosis were not associated with significantly poorer outcomes. Estimated 10-year EFS was 38%, 23% and 7% for patients with 0-1, 2-3 or > or =4 of the adverse prognostic characteristics identified by the International Prognostic Factors Project, respectively.


CONCLUSIONS
The prognostic score for advanced disease is also useful for relapsed and refractory Hodgkin's disease patients undergoing high-dose therapy followed by autologous hematopoietic stem cell transplantation.
Department of Internal Medicine, Section of Oncology-Hematology, Omaha, NE 68198-3330, USA. pjbierma@unmc.edu
P J
PJ
Bierman
J C
JC
Lynch
R G
RG
Bociek
V L
VL
Whalen
A
A
Kessinger
J M
JM
Vose
J O
JO
Armitage
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D000740:Anemia / Q000175:diagnosis; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D007391:International Cooperation; D008231:Lymphopenia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy; D012720:Severity of Illness Index; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome