Summary: Retrospective study to identify diagnostic and prognostic factors for remission rate and survival in variants of Hodgkin's disease. Included all 155 patients who received the diagnosis of Hodgkin's disease in Grenoble from January 1975 to January 1990.
Clinical investigations, diagnosis, staging and therapy followed accepted international recommendations. Immunohistochemical investigation was performed with monoclonal antibodies against epithelial membrane antigen (EMA), Leu-Ml/CD15, leucocyte common antigen (CD-45) and keratin. Duration of complete remission and survival were recorded. Survival curves were established using the actuarial method. Multifactorial analysis was made according to Cox's regression model. The prognostic factors chosen for multifactorial analysis were those established by monofactorial analysis.
Multifactorial analysis selected for duration of complete remission in order: EMA (—), age < 50 years, histologic types 1, 2 and 3 and for survival in order: age < 50 years, EMA ( —), histologic type 1, 2 and 3 and Leu-Ml (CD15/+). Severity of the disease and staging were not recognised as independent prognostic factors. Histologic type 4, characterised by lymphocyte depletion, had bad prognosis. It differed in clinical manifestations, anatomical localisation and prognosis. It probably should be considered as a special disease entity, separate from Hodgkin's disease.
Multifactorial analysis revealed that, besides age epithelial membrane antigen was the most important independent factor predisting bad prognosis. Histologic type 4, characterized by lymphocyte depletion, and which was allways EMA (+) also predicted bad prognosis. It should be considered as a separate disease entity.
A multifactorial analysis of prognostic factors in Hodgkin's disease
