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Prognostic Factors for Follicular Lymphoma

by Indranil Mallick, M.D.
for About.com

Updated May 01, 2007

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

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.

Age:

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.
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