Prognostic factors in Hodgkin's disease stage IV

104 patients with previously untreated Hodgkin's disease stage IV were examined and treated at the Finsen Institute between 1969 and 1983. 99 patients were treated with combination chemotherapy (MOPP or equivalent regiments) with or without additional irradiation of some involved areas. Prognostic factors including age, sex, peripheral plus intrathoracic nodal tumour burden, intraabdominal nodal tumour burden, B-symptoms, histologic subtype, number of involved nodal regions, mediastinal involvement, number of involved extranodal sites, type of extranodal involvement, ESR, and haematologic and other blood values, together with exploratory laparotomy and treatment were examined in multivariate analyses. With regard to disease-free survival, the only factors of independent prognostic significance were sex and lymphocytopenia. With regard to overall survival the factors of independent significance were age, sex, bone marrow involvement, and an elevated serum creatinine. If only deaths of Hodgkin's disease were considered in overall survival, both lymphocytopenia and bone marrow involvement had independent prognostic significance. These two factors thus emerged as the most important prognostic factors in disseminated Hodgkin's disease, and both would appear to be related to the patient's total tumour burden.