Re-staging

I received a call from my Oncologist today to tell me that a committee, after reviewing my CT scans, has decided that I have stage IV HL not stage III.  This is due to the pericardial effusion and masses in my lungs.  The committee still believes the original treatment plan is the best course of action so I will start six cycles of ABVD on April 1^st 2011.

My Hasenclever Hodgkin’s Prognosis Score (IPS) is 3.  This means I have a predicted 5-year freedom from progression of disease of 60% and overall survival rate of 78%.  The Hasenclever system was developed in 1998 using data from patients who were treated with ABVD or MOPP chemo regimens.  The risk factors in the Hasenclever system which are present in my case are: sex (male), stage IV disease and white blood count ≥ 15,000/µl. When I had my first CBC in January 2011 my WBC was below the threshold to be considered a risk factor based on Hasenclever. 

Other studies have shown the most important adverse prognostic factors are: mixed-cellularity or lymphocyte-depleted histologies [no], male sex [yes], large number of involved nodal sites [yes], advanced stage [yes], age of 40 years or more [no], the presence of B symptoms [yes], high erythrocyte sedimentation rate (results not in yet), and bulky disease (widening of the mediastinum by more than one third, or the presence of a nodal mass measuring more than 10 cm in any dimension) [no].