Prognostic factors determine both choice of treatment and ultimate outcomes:
Follicular lymphoma is a slow growing disease, and often doctors do not advise immediate treatment, preferring to wait till an individual becomes symptomatic. The course of the disease and the treatment given depends on a handful of factors. Some are related to the disease and some to the person affected. They make up the 'Follicular Lymphoma International Prognostic Index' or FLIPI. Here is a discussion on these factors and how they affect the ultimate results.
The disease stage:
This is a very important prognostic factor. Read more about staging in Understanding Lymphoma Stages. Early stage disease - Stages I and II may be treated in a completely different manner compared with advanced stage disease - stages III and IV. The outcomes are also very different. Early stage disease is usually cured, while advanced stage disease being rarely curable.
The number of lymph node sites involved:
Lymphoma most commonly presents with lymph node swellings. If lymph node masses are seen in more than four different areas, the results of treatment are worse.
Blood test results:
You may have to undergo a number of blood tests once you are diagnosed with lymphoma. Two blood test reports make a difference in prognosis. A high value of lactate dehydrogenase (LDH) and a low value of Hemoglobin (less tha 12 gm/dl) predict worse outcomes.
The age of the individual is a very important prognostic factor. Persons less than 60 years of age tend to have better outcomes than older individuals.
How does it all add up?:
Based on the five factors mentioned above, follicular lymphoma is divided into 3 risk groups:
- Low Risk (0 or 1 factor) - chances of surviving 10 years is 70%.
- Intermediate Risk (2 factors) - chances of surviving 10 years is 50%.
- High Risk (3 to 5 factors) - a 35% chance of surviving 10 years.