Hodgkin’s Lymphoma: An Environmental Scan
Table of Contents
3.9 Prognosis and Survival Estimates
The whole purpose of assessing a patient’s prognosis is to forecast how well the patient will do in recovering or at least experiencing long periods of remission of the cancer as a result of treatment and other factors. Over the course of diagnostic advancements, effective treatment options and developments in reducing the late effects of standard treatments, Hodgkin’s lymphoma is a cancer that has very positive characteristics concerning prognosis. The prognosis is excellent for the majority of individual’s with HL.
The individual prognosis a patient is given is an estimate derived from numerous clinical and statistical pieces of information gathered on large groups of patients; therefore, a prognosis is the clinician’s best guess of how a particular patient may do in treatment, but the information used to derive a prognosis for a patient is not directly applicable to any one individual and a great deal of variation in how patients fair in treatment is possible.
The International Prognostic Score (IPS) is the standard that is used and specifically has 7 factors that are considered when estimating how an individual will fair through their HL disease process:
- Stage of the disease
- Hemoglobin, Albumin and Lymphocyte levels
- White cell counts
Individuals who receive a diagnosis of HL in later stages, who are older, have bulky tumors (see page 9); multiple lymph nodes affected are all at an increased risk of relapse, resulting in a poorer estimate of prognosis (Lymphoma Research Foundation 2009). Overall, approximately 20% of patients will continue to experience progressive disease and death despite successful treatments for HL (Steidl et al. 2010) (Cuenca, Xhaard, and Mounier 2009). Specifically regarding NLPHL, standard treatments lead to approximately a 95% complete remission (Nogová, Rudiger, and Andreas Engert 2006).
Furthermore, research has focused on additional factors not included in the IPS such as the patient’s socio-economic (SES). One hypothesis suggests that access to and the quality of health care may impact overall treatment outcomes (Booth et al. 2010). A 2006 Brazilian study, specifically following patients who had HL for 5 years found a relationship between socio-economic status (SES) and complete remission rate (CR) where individuals with a higher SES had an 85% remission rate compared to 72% among those self-reporting a lower SES (Soares et al. 2007). Other cancer research supports this finding concerning several different types of cancer and the success of treatment. Statistically, 85-95% of patients survive HL especially when the disease is diagnosed and treated early (DeVita and Jose Costa 2010) and Hodgkin’s lymphoma has a 5 year survival rate of approximately 90% (Bendall 2010). Additionally, survival rates of individuals with HL differ geographically with Europe having shorter survival rates compared to the United States (Allemani et al. 2006).