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Lymphoma Staging, Prognosis and Therapy Response Assessement System
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  Type of Lymphoma: Non-Hodgkin Follicular Non-Hodgkin Diffuse Large B-cell Lymphoma Other Non-hodgkin lymphoma Hodgkin Lymphoma               Reset All
Ann Arbor Staging with Modifiers:
I

Involvement of a single lymph node region

IE

Involement of a single extralymphatic organ or site


II

Involvement of two or more lymph node regions on the same side of the diaphragm

II E

Localized involvement of an extralymphatic organ or site and one or more lymph node regions on the same side of the diaphragm


III 

Involvement of lymph node regions on both sides of the diaphragm

III S

Which may be accompanied by involvement of the spleen

III E

Localized involvement of an extralymphatic organ or site

III SE

Both Localized involvement of an extralymphatic organ or site and spleen


IV

Diffuse or disseminated involvement of one or more extralymphatic organs or tissues with or without associated lymph node involvement

Constitutional Symptoms

Absence of fevers( above 38 degrees C ), night sweats, weight loss of more than 10% of usual body weight in the 6 months prior to diagnosis

B

Presence of fevers( above 38 degrees C ), night sweats, weight loss of more than 10% of usual body weight in the 6 months prior to diagnosis.


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Assessment of prognosis

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Follicular Lymphoma

Age:

Number of Nodal Sites:

Serum LDH:

Haemoglobin:

Stage:

International Prognostic Index. Blood 104:1258-1265. (2004)

View abstract | View full text




Diffuse Large B-cell (Revised IPI - Rituximab)

Age:

§ ECOG Performance Status:

Serum LDH:

External Sites:

Stage:

Revised International Prognostic Index was developed by Sehn et al. Blood 109:1857-1861. (2007) View abstract | View full text

§ECOG: Eastern Cooperative Oncology Group scale: 0 No Symptom, 1 Symptoms but ambulatory, 2 Bedridden less than half the day, 3 Bedridden half the day or longer, and 4 Chronically bedridden and requires assistance with the activities of daily living.
All Other Non-Hodgkin Lymphoma

Age:

Serum LDH:

External Sites:

Stage:

International Prognostic Index. Blood 104:1258-1265. (2004) View abstract | View full text







Advanced Hodgkin (Hasenclever IPI)

Age:

Gender:

Serum Albumin:

White-cell count:

Stage:

Lymphocyte count:

Hasenclever International Prognostic Index. Blood 109:1857-1861. (2007) View abstract | View full text





















Interim PET/CT Deauville Criteria:

No Uptake

Uptake ≥ mediastinum

Uptake>mediastinum but ≤liver

Uptake moderately more than liver uptake, at any site

Markedly increased uptake at any site and new sites of disease

M. Meignan, A. Gallamini, M. Meignan, A. Gallamini, and C. Haioun, “Report on the first international workshop on interim-PET-scan in lymphoma,” Leukemia&Lymphoma, vol. 50, no. 8, pp. 1257–1260, 2009.

Post Therapy PET/CT Response Criteria§:

FDG-Avid at Baseline? Yes No 

FDG-Avid at Baseline:

Complete resolution of FDG-avid lesions and negative result of bone marrow biopsy.

> 50% decrease in sum or product of diameters of lesions with persistent residual FDG uptake in at least one site.

Any new FDG-avid lesion;≥ 50% increase in sum or product of diameters of previously involved sites with respect to nadir sum or product of diameters associated with abnormal FDG uptake; or new or recurrent bone marrow involvement.

No complete remission, partial remission, or progressive disease.

§Summerized by Carmel et al.  [Clinical Utility of PET/CT in Lymphoma, © American Roentgen Ray Society. AJR 2010; 194:W91-W103 View abstract | View full text ]
from the original paper by Cheson et al. [The International Harmonization Project on Lymphoma: revised response criteria for malignant lymphoma. J Clin Oncol 2007;25 : 579–586 View Abstract | View Full Text]

No FDG-Avid at Baseline:

Return to normal size of lymphadenopathy with complete resolution of extranodaldisease

> 50% decrease in sum or product of diameters of lesions

Any new lesion > 1.5 cm in any axis;50% increase in sum or product of diameters of previously involved sites with respect to nadir sum or product of diameters; or new or recurrent bone marrow involvement

No complete remission, partial remission, or progressive disease

§Summerized by Carmel et al.  [Clinical Utility of PET/CT in Lymphoma, © American Roentgen Ray Society. AJR 2010; 194:W91-W103 View abstract | View full text ]
from the original paper by Cheson et al. [The International Harmonization Project on Lymphoma: revised response criteria for malignant lymphoma. J Clin Oncol 2007;25 : 579–586 View Abstract | View Full Text]