Costwold Modified Ann-Arbor Staging
I: 1 Lymph Node (LN) region (I) or 1 Extralymphatic site (IE)
II: On the same side of diaphragm – ≥2 LN region (II) or Localized Extralymphatic extension + ≥1 LN region (IIE)
III: On both the sides of diaphragm – LN regions (III) ± Spleen involvement (IIIS) ± Localized Extralymphatic extension (IIIE) or both (IIISE)
IV: Noncontiguous involvement of ≥1 Extralymphatic site with or without LN involvement
Annonations
A: Asymptomatic or Absence of B symptoms
B: B symptoms – ≥1 in last 6 months:
- Weight loss > 10%
- Unexplained persistent or recurrent fever
- Drenching night sweats
X: Bulky disease (≥6 cm in diameter or mass > 1/3 of mediastinal diameter)
E: Extension to a single Extralymphatic organ adjacent to a known involved site.
International Prognostic Score (IPS)
Mnemonic: HALSWAM
- Hemoglobin: <10.5 gm/dl
- Age: ≥ 45 years
- Lymphocytopenia: Lymphocyte count < 8% of WBC or <600/cu.mm
- Stage: IV
- WBC: >15,000/cu.mm
- Albumin: <4 gm/dl
- Male gender
Interpretation:
- None: 84% FFP (Free From Progression) at 5 yrs
Presence of each factor depresses the curve plateau by ~8%.
- 1: 77%
- 2: 67%
- 3: 60%
- 4: 51%
- 5+: 42%
