A 73-year-old man presents with fatigue and multiple lymph nodes in his neck. He has multiple large nontender lymph nodes in his neck and axilla. The spleen is not palpable, and the remaining examination is normal. A biopsy of the lymph node reveals lymphocytic lymphoma. Which of the following factors predicts poor prognosis?
(A) no extranodal involvement
(B) poor performance status
© age <60
(D) low serum lactate dehydrogenase (LDH) levels
(E) fever and weight loss
solution:
(B) Prognosis of patients with non-Hodgkin’s lymphoma is best assessed with the International Prognostic Index. It is an index with five clinical risk factors that helps to predict the 5-year survival. Poor prognostic factors are age >60 years, high serum LDH level, poor performance status (either Eastern Cooperative
Oncology Group [ECOG] >2, or Karnofsky <70), Ann Arbor stage III or IV, or >1 extranodal involvement