Prognostic Scores In Early Stages British National Lymphoma Investigation BNLI index

In 1985, Haybittle and coworkers reported that age, gender, mediastinal involvement, pathologic grade based on histologic subtype, and erythrocyte sedimentation rate were independent prognostic factors on cause-specific survival in clinical stage I-IIA patients.12 Using these factors, they derived a quantitative prognostic index based on the results of multivariate regression analysis performed on data from 743 patients. This index was expressed as follows:

1 = 0.05 (age in years) + 1.0 (mediastinal involvement, coded 1 for uninvolved mediastinum, 2 for involved mediastinum) + 2.0 (pathologic grade, coded 1 if lymphocyte predominant or nodular sclerosing type 1, or

2 if nodular sclerosing type 2 or mixed cellularity) + 1.0 (erythrocyte sedimentation rate, coded 1 if below 10 mm/1st hour, 2 if between 10 and 39 mm/1st hour, and 3 if 40 mm/1st hour or above) - 1.2 (gender, coded 1 for male, 2 for female).

The index ranged from 2.5 for a young girl aged 15 without adverse factors to 11.5 for a man aged 70 with all adverse factors. In the BNLI series, the value of the index was I < 5.0 in 32% of patients, 5.0 < I < 7.5 in 52%, and I > 7.5 in 16%. A high index value (I > 7.5) corresponded to high-risk patients, while patients with I < 7.5 had a low risk of cause-specific death whatever the level of the index.

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